| NPI | 1346759677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITA EDMAN COO 631-329-6415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VT 0651) |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |