| NPI | 1821817628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA MASCIOCCHI Owner 267-352-3730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-10-08 |