| NPI | 1295139822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORI ALLISON BROWN Lcsw 631-772-9644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 60312005) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |