| NPI | 1619140241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE BACCHUS Ar Spervisor 917-408-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |