| NPI | 1447766993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA GRANATH Social Worker 631-848-6399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2017-12-20 |