| NPI | 1457626012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL STETSON Director 315-437-1304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY R070144) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |