| NPI | 1366890949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J ROCHE Director 631-235-4481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NY 004685) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2021-04-25 |