| NPI | 1962114603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISET MACIAS Officer 347-614-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2024-09-23 |