| NPI | 1730207119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY LEAVITT Executive Director/CEO 212-991-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NY 210573) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 136328) |
| 261QP2300X Clinic/Center, Primary Care (Licence: NY 211187) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2015-06-24 |