| NPI | 1770234650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH CHELALES Administrator 646-285-4035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |