| NPI | 1578261277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEBISI BAMMEKE CEO 631-568-7893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-02-21 |