| NPI | 1619104239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN COSTIN Executive Director 718-250-4833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 72079127) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2009-06-23 |