| NPI | 1710252127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD R LEE-EDWARDS Owner 347-500-7785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY 4053692) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |