| NPI | 1467769398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACQUEL YILLA CEO 631-848-3740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 044-01-850-2) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2012-06-02 |