| NPI | 1245831528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN GREEN Executive Director 917-985-0987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| 252Y00000X Early Intervention Provider Agency | |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 305S00000X Point of Service | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |