| NPI | 1497380893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ALEXANDER JONES Executive 917-557-4757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-03-05 |