| NPI | 1154711612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH PEREZ Executive Director 212-663-1975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-04 |