| NPI | 1649329806 |
|---|---|
| Former Legal Business Name | QUEENS CHILD GUIDANCE CENTER, INC. |
| Entity Type | Organization |
| Authorized Contact | JEAN M COPPOLA Billing System Administrator 718-651-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2017-01-18 |