| NPI | 1598104283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA OSTRANDER Registered Nurse 315-507-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NY 658138-1) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NY 658138-1) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |