| NPI | 1619598042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA AIDA CHACON Act Team Assistant 718-634-3445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |