| NPI | 1245697812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN E ECCLES Controller 212-886-5617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 60160449) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |