| NPI | 1396786695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUSTAVE STEPHEN DRIVAS Doctor/President 718-232-1910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NY 186334) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-08-22 |