| NPI | 1205298890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL M RIES Clinician 646-902-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 001803) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |