| NPI | 1447607817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREISLY VILLAMAN Medical Biller 914-375-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2020-01-15 |