| NPI | 1578941746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRUDENCE HEISLER Otr/L 212-473-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 0196551) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-08 |