| NPI | 1124365903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE GRACE PALASKI Registered Nurse 929-888-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 659746) |
| Enumeration Date | 2013-01-13 |
| Last Update Date | 2013-03-18 |