| NPI | 1174784383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY KNAUST Clinical Supervisor 718-428-2640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 075936) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-06-19 |