| NPI | 1366988362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA NICOLE SAM Fee For Service Therapist 212-665-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 084660) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |