| NPI | 1306475751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ROSS Chief Executive Officer 917-903-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2023-12-28 |