| NPI | 1336659879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE SIMON Owner 917-572-8114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NY 056118) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2019-11-07 |