| NPI | 1447966130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN INGRAHAM Owner 607-221-2032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-01-25 |