| NPI | 1831821289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ANTHONY DUCOS Clinical Director 347-620-3339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-25 |
| Last Update Date | 2022-07-19 |