| NPI | 1578615423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUNG R. DO Executive Director 518-434-6468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NY 061210043) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-03-05 |