| NPI | 1962958090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY QUIROZ Owner 516-330-1102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA PSY27130) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2025-03-10 |