| NPI | 1891186029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE BEAUREGARD-WEISS Provider Administrator 917-470-0284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2024-08-02 |