| NPI | 1255507497 |
|---|---|
| Former Legal Business Name | MOUNTAIN LAKE CHILDREN'S RESIDENCE, INC. |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MARIANO CEO 518-523-4300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2025-02-06 |