| NPI | 1477765733 |
|---|---|
| Other Name | ICC WEBSTER ST TRMT APT JUNCTION |
| Entity Type | Organization |
| Authorized Contact | HEATHER MARIE BARNEY Credentialing Manager 518-651-2302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NY 7533430) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2022-08-09 |