| NPI | 1790088854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS LYNN TABISEL Owner/President 516-576-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY R013521-1) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2010-12-13 |