NPI | 1356184493 |
---|---|
Entity Type | Organization |
Authorized Contact | CHENIQUE L BOUTELLE Owner 518-487-9950 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2024-06-17 |
Last Update Date | 2024-06-17 |