| NPI | 1710546155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA SENIOR Lead Therapist, Manager 917-496-4691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |