| NPI | 1649474552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY SMITH Op Business Manager 518-952-8408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NY 080511619) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-12-23 |