| NPI | 1255643193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY PADGETT Substance Abuse Counselor Ii 718-665-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 302R00000X) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |