| NPI | 1568279461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MILLER Owner 917-805-1765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2024-12-13 |
| Last Update Date | 2025-12-10 |