| NPI | 1164473831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL COUNTRYMAN Executive Director 518-725-4310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2018-04-27 |