| NPI | 1275049884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENRICK ALFRED Chairman Of The Board 631-575-8062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2019-06-11 |