| NPI | 1114130317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER M FENNIMORE RN 718-645-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 226653) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-02-19 |