| NPI | 1861803629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERON ELAINE JOSEPH Owner 917-755-5185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL AL12486) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-05-15 |