| NPI | 1447811211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L KORAL Clergy Board Consultant 212-874-5210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2019-06-24 |