| NPI | 1629347620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MOLLER Owner/Managing Member 718-360-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2019-10-12 |