NPI | 1649861873 |
---|---|
Former Legal Business Name | JASON DUCOS, LCSW |
Entity Type | Organization |
Authorized Contact | JASON DUCOS Owner 347-217-6252 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2021-01-31 |
Last Update Date | 2021-01-31 |