| NPI | 1457650392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS O'DELL CEO 516-671-1253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2014-11-14 |