| NPI | 1326859547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALECIA R HUERTAS Accounts Receivable Manager 631-669-5355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-01-16 |