| NPI | 1891082004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA ABALOLA Staff Nurse 646-401-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NY 23709380) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2011-07-08 |