| NPI | 1902993272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BOURBIIN Psychiatric Social Worker 631-854-2571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: NY R0497521) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |