| NPI | 1518605351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS LEWIS 1/3 Owner 917-474-3792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-10-25 |