| NPI | 1760831119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ETWARU Owner 212-804-7318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |