| NPI | 1417491010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE FAIRBAIRN-BLAND CEO 917-620-0722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 083087) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |