| NPI | 1881225217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GERALD MORAN Owner 646-298-5227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |