| NPI | 1447981477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERTO LESLIE Owner 646-270-2269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2024-08-23 |