| NPI | 1639545437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRANJIT K LONGAKER Owner 607-592-6539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 006416) |
| Enumeration Date | 2015-08-15 |
| Last Update Date | 2018-10-26 |