| NPI | 1730379504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA A PETTEYS Director Op Billing 518-952-8140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NY 081110730) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2021-04-29 |