| NPI | 1558983908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVIVA BAUER Owner 929-410-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-10-22 |