| NPI | 1700016565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIELA SUSAN FLAXMAN Ma Ccc Slp 212-499-0691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 001073-1) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |