| NPI | 1013474113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ROBERTS Ex. Director 518-929-0631 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |