| NPI | 1518527969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D CAMPBELL Manager 516-242-2354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-12-01 |