| NPI | 1568919819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ROSS CEO 917-903-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-09-03 |
| Last Update Date | 2023-01-13 |