| NPI | 1336614296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY MANNE CEO 917-662-7192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |