| NPI | 1417327016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW J ERVIN CEO 646-661-2537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |