| NPI | 1083867204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EDBAUER Medical Director 716-828-9357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NY F335624-1) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2008-10-31 |