| NPI | 1689307480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWINA JOHNSON Owner 914-338-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2024-12-26 |