| NPI | 1578137121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER E DONNELLY-GREENBERG Clinical Psychologist 631-209-7917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2024-01-30 |