| NPI | 1912720079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYOOLA O. FADEYI CEO 917-445-2420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X | |
| 261Q00000X Clinic/Center | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2024-11-06 |