| NPI | 1992338164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA RAUFMAN Provider 917-617-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-07-02 |