| NPI | 1750011847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSANTHE CARATURO Site Administrator 516-474-1561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-10-31 |