| NPI | 1316484272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELON KENDRICKS Licensed Clinical Social Worker 917-363-4063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NY 034280) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |