| NPI | 1215589197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT SHKLYAR Officer 516-343-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2021-07-09 |