| NPI | 1649981226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVON D TELFORD CEO 518-522-3854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 174200000X |
| 253Z00000X In Home Supportive Care | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2022-12-05 |