Provider First Line Business Practice Location Address:
NORTH COUNTY COMPLEX CLINIC YOUTH ADULT PROGRAM
Provider Second Line Business Practice Location Address:
BLDG 151
Provider Business Practice Location Address City Name:
HAUPPAUGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11788
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-853-6340
Provider Business Practice Location Address Fax Number:
631-853-6338
Provider Enumeration Date:
05/07/2007