| NPI | 1174072003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOT LIEBHARD Administrator 917-374-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |