| NPI | 1619403219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GREEN Life Coach 631-553-7131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |