| NPI | 1689332561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YANET PERDOMO Owner 646-295-2738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2023-08-23 |