| NPI | 1992146815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MORGAN ROFF Director 917-714-8821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X (Licence: WA CG60372901) |
| 251S00000X (Licence: NY 001327) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2014-06-20 |