| NPI | 1679202618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE ISSAC Owner / Provider 718-614-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-06-06 |