| NPI | 1235951674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KRUGOLETS Operations Manager 718-813-9924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |