| NPI | 1780381665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAKIMA GONZALEZ Licensed Clinical Social Worker 347-605-3518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |