| NPI | 1285928119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK LEWIS Executive Director 518-372-1160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2023-06-26 |