| NPI | 1699057539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIAN GRAHAM President/ C.E.O 718-801-6336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NY 274597557) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2011-09-16 |