| NPI | 1992456255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF EVANS Admissions Coordinator 646-761-9659 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |