| NPI | 1144768581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD HYDER Owner 315-664-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |