| NPI | 1366943284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBBY PATRICK FOSTER Licensed Mental Health Counselor 631-493-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 008421) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-05-10 |