| NPI | 1851276455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIMON GOLDBERG Director 917-455-9179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-11 |