| NPI | 1639737299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDIE FARRELL Owner 646-477-5398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2024-03-04 |