| NPI | 1225524010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ALAN WHEATLEY Administrator 917-783-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL13168) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |