| NPI | 1417314154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL LAZO MONTANEZ Program Director 718-898-5085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NY 096826) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-01-26 |