| NPI | 1578955951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIA NELSON Program Administrator 718-518-3736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 0738591) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |