| NPI | 1497823256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M DOLD Controller 718-906-5440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: NY 7455462) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |