| NPI | 1508391756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GREEN Life Coach 631-553-7131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |