| NPI | 1245634427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA ITALIANO Supervisor 718-333-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 103K00000X) |
| Enumeration Date | 2014-10-16 |
| Last Update Date | 2014-10-16 |