| NPI | 1194603225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARISE CHRISTIAN Director 631-600-2646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251X00000X Supports Brokerage | |
| 253Z00000X In Home Supportive Care | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1000X Clinic/Center, Migrant Health | |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2025-08-26 |