| NPI | 1316080468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK O'BRIEN Executive Director 716-648-1964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NY 04-58865) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |