| NPI | 1245845932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAKE COOPER Chief Executive Officer 347-851-1139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 103TF0000X Psychologist, Family | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2024-05-13 |