| NPI | 1467907733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIA COREA CEO, Mental Health Counselor 516-280-7285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 005894) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2022-04-26 |