| NPI | 1306441167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY R LEVY Director 315-800-8333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 172V00000X Community Health Worker | |
| 222Q00000X Developmental Therapist | |
| 224Z00000X Occupational Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| 251E00000X Home Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2020-12-01 |