| NPI | 1629383484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA SPORN Nurse 516-481-0052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 584123-1) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2010-08-17 |