| NPI | 1750877783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE MA Owner 718-690-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: NY 091380) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |