NPI | 1871204073 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL E JOHNSON Managing Member 646-645-2108 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2022-12-08 |
Last Update Date | 2022-12-08 |