| NPI | 1508272238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA O Coding And Credentialing Supervisor 607-302-0442 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NY 18-006023) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2025-03-14 |