| NPI | 1427276542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOOSAN BUSHEHRI TEHRANI Controller 914-428-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2008-04-02 |