| NPI | 1770122947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTAL SAMPSON Owner, Clinician 347-622-9524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-01-05 |
| Last Update Date | 2020-01-05 |