| NPI | 1528347978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN PICCOLA Team Leader 631-669-5355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 500751) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2011-08-16 |