| NPI | 1639391733 |
|---|---|
| Other Name | CHURCH STREET ICF |
| Entity Type | Organization |
| Authorized Contact | GREGORY I LANGDON Executive Director 518-483-1251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 6521454) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |