| NPI | 1710024120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH A D'AMORE Executive Director 315-424-1845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NY 8686440) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NY 8686441) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NY 8234430) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 8686442) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 8686443) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-01-04 |