| NPI | 1922171289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA DELAROSA Billing Director 718-401-5644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-11-28 |