| NPI | 1568749968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SNYDER LOOMIS Clinical Therapist 315-252-6978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY R054031-1) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-23 |