| NPI | 1265767123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE BRUNNER Lmsw 631-427-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 072457-1) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2009-10-12 |