| NPI | 1386194124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER CAMPBELL Billing Officer 718-498-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |