| NPI | 1164763348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE C MARSEILLE Pharmacist 631-761-2737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NY 040358-1) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-04-03 |