| NPI | 1720171440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY LONG Executive Director 315-476-5103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |