| NPI | 1770330003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN WEBER Owner/Provider 917-583-5218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-15 |