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 |