| NPI | 1154691368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE TISNE Associate Director 914-666-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: NY 100911477) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2020-02-28 |