| NPI | 1558103440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JACKSON Cco 585-721-0294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |