| NPI | 1619732013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL S ZIMMERMAN Owner 347-443-1486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-05-24 |