| NPI | 1285287086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE JANELLE GILL Owner 718-570-3446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-20 |
| Last Update Date | 2019-07-20 |