| NPI | 1760748479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA PAUL President 718-360-0689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |