| NPI | 1316811995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFSANJANI ABDUSHAHID Owner 607-353-9368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2025-10-06 |
| Last Update Date | 2025-10-06 |