| NPI | 1225483332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEFIM GORBERG Owner 267-538-8610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |