| NPI | 1730894577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASSIELLE MORALES-MILLER Owner 631-238-1565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-01-17 |