| NPI | 1346659877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY PHILIPPE Organizer 917-647-7816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 001355) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2014-08-08 |