| NPI | 1861100646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR DELBRUNE Billing Coordinator 917-362-4332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2022-12-07 |