| NPI | 1215061080 |
|---|---|
| Other Name | BROOME DDSO - CLINIC |
| Entity Type | Organization |
| Authorized Contact | EARL JEFFERSON Director Of Central Operations 518-402-4333 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: NY 00233170) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2016-01-06 |