| NPI | 1346618212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE MARLY SURIN Lpn 845-300-3886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NY 313619-1) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |