| NPI | 1588100986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARD V HALVERSON Owner 315-868-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R052659-1) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |