| NPI | 1750934436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORA CARRERO Director Of Credentialing 718-907-6236 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2019-07-22 |