| NPI | 1588983902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAID A IBRAHIMI Resident 518-334-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2010-05-25 |