| NPI | 1144423062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E BOOTH Director 718-983-5321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 006544) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2023-03-07 |