| NPI | 1932041902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAIAH TANISHA LASSALLE Owner And Member 845-288-1776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2026-04-08 |
| Last Update Date | 2026-04-08 |