NPI | 1649442229 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA MOJICA Billing And Credentialing Manager 917-485-7291 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: NY 6396001A) |
Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities (Licence: NY 070311541) |
261QM1300X Clinic/Center Multi-Specialty | |
Enumeration Date | 2008-03-24 |
Last Update Date | 2022-03-17 |