| NPI | 1003257726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE MANUEL President 518-522-3628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904007238) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |