| NPI | 1588109953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDSON COOK Owner 845-321-2049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2017-04-22 |