| NPI | 1659746055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN KAHOUD Owner 516-479-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 021201) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2022-04-29 |