| NPI | 1952997397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID MCFARLANE Partner 347-906-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2020-12-20 |
| Last Update Date | 2020-12-20 |