| NPI | 1588006159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE T SACK Owner/ Clinical Social Worker 315-247-3208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY R052758-1) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |