| NPI | 1730873779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALID BAKER CEO 917-533-0368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2025-04-28 |