| NPI | 1932727419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISIAH MICHAEL Managing Member 917-873-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |