| NPI | 1467811059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGER LATRONDA FORD Clinical Substance Abuse Counselor 347-731-9159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NY 30303) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-11 |