| NPI | 1801377577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN ELIZABETH WYNN President 917-733-2899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 083839-1) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |