NPI | 1568009041 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBORA CARRERO Director Of Credentialing 718-408-6522 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2019-12-04 |
Last Update Date | 2019-12-04 |