| NPI | 1659142693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHILDE MICOMYIZA CEO 347-828-1706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-01-09 |