| NPI | 1114410701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A. HOSTIG Sole Owner 518-222-6752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY R075574-1) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-07-24 |