| NPI | 1407337512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENORE FELICE CANAVARROS CEO 631-327-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12524) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |