| NPI | 1144709445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYANN FOSTER Owner 716-400-0762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |