| NPI | 1043981731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY M BARSUK Member 716-465-9532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2023-09-14 |