| NPI | 1912461773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAILJA BHATTA Credentialing Specialist 212-366-4459 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-28 |