| NPI | 1053766816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIESE GRIFFITHS Senior Biller 914-220-4353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2016-04-29 |