| NPI | 1750934436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORA CARRERO Director Of Credentialling 718-408-6522 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2025-10-27 |