NPI | 1326648171 |
---|---|
Entity Type | Organization |
Authorized Contact | HILLARY FITZSIMMONS Owner 315-559-9762 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2020-10-30 |
Last Update Date | 2020-10-30 |