| NPI | 1477299683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL GOLDNER Authorized Person 516-727-1634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2022-09-08 |