| NPI | 1558972141 |
|---|---|
| Former Legal Business Name | SHOOTING STAR COUNSELING LLC |
| Entity Type | Organization |
| Authorized Contact | JESSE COUDRAY Owner 646-271-7912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |