| NPI | 1215485784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIN ROACH Owner 917-272-4687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000624-1) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 17443) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |