| NPI | 1790327179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA YOUNG Owner 917-669-8823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2021-12-13 |