| NPI | 1497415137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF EVANS COO 646-761-9659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2022-01-10 |