| NPI | 1770278228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXA MORGENROTH Director Of Administration 631-220-0630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2024-01-04 |