| NPI | 1134677214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADREAMA T MACON Mental Health Therapist 631-294-5634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253J00000X Foster Care Agency (Licence: NY 087757) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |