| NPI | 1396315610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT LIEBHARD Owner 917-374-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2023-10-04 |