| NPI | 1720765167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ECLENA MATEL Administrator 929-313-8247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2023-06-28 |