| NPI | 1316646607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO EDGARDO BELTRAN Clinical Social Worker 631-575-3435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-10-01 |