| NPI | 1629434451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL ANTHONY MARINO Lpc / CEO 585-975-9216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 9058) |
| Enumeration Date | 2016-01-09 |
| Last Update Date | 2016-01-09 |