| NPI | 1689009250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JOHNSON Director 1914-413-8029 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 20992) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-09-13 |