| NPI | 1275795098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER J DAVISON Secretary 2 315-541-2117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NY 0025261) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: CT 042539) |
| 282N00000X General Acute Care Hospital (Licence: CT 042539) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2009-10-12 |