| NPI | 1962993121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNY E GONELL Propriator 516-731-0683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2024-10-23 |