| NPI | 1316153109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADDIE HAMPTON President 631-661-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 12290) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 0005621) |
| 164W00000X Licensed Practical Nurse (Licence: NY 098015) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |