| NPI | 1588066716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARRUKH KHWAJA Manager 516-458-7898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2024-09-06 |