| NPI | 1710957683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY VELASQUEZ Billing And Contracting Manager 347-963-8562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2026-03-13 |