| NPI | 1881092088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY NATHANIEL BAKER Owner 718-377-3168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 180898) |
| Enumeration Date | 2014-12-21 |
| Last Update Date | 2014-12-21 |