| NPI | 1265020259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY SMITH Business Office Manager 518-952-8408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2024-12-26 |