| NPI | 1215543376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE INTERVALLO CEO/Clinical Director 914-619-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2021-04-19 |