| NPI | 1366938839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER A CRAWFORD President 917-968-0532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-07-07 |
| Last Update Date | 2018-07-07 |