| NPI | 1992503759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAEIDEH GOLJI Member Manager 929-722-1316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-03-06 |