| NPI | 1912541210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ESPELIN Business Manager 347-762-5352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2022-04-20 |