| NPI | 1194450510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA SWANSON Owner 646-402-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2022-07-20 |