| NPI | 1083004907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER G LEVINE Owner 315-469-2827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NY 172860) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |