| NPI | 1326306747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERCENIA MARIA COLEMAN Administrator 646-731-8198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WI 320900000x) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-04-24 |