| NPI | 1588686596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY PORTER Fiscal Administrator 607-274-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 6892300A) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-03-21 |