| NPI | 1821636226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISSY CHISOLM Director 516-314-8460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |