| NPI | 1417408485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD LARDIZABAL President/Member 845-701-1852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2019-08-01 |