| NPI | 1508182072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YISSELL DELVALLE President 917-345-4273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: NJ 25MA0821070) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2022-12-07 |