| NPI | 1770954570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SCOTT STANTON Director 347-466-3047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |