| NPI | 1730420985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD WAYNE BETHEA Clinical Director 718-802-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 003346) |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2013-03-13 |