| NPI | 1750071114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE UKEYE Manager 347-385-8314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-09 |