| NPI | 1609236330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL MICHAEL COYLE CEO 315-425-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2021-01-13 |