| NPI | 1356050686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ROSS CEO 917-903-7445 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2023-07-11 |