| NPI | 1497330823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVON MARTINDALE DONOHUE Sole Member 585-902-9012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-03-17 |