| NPI | 1407699135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS POLONY Counselor 716-770-2359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |