| NPI | 1154835304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SERFATY Mental Health Counselor 347-352-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180.008982) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2021-11-04 |