| NPI | 1750469912 |
|---|---|
| Other Name | IBR GEORGE A JERVIS CLINIC |
| Entity Type | Organization |
| Authorized Contact | EARL JEFFERSON Director Of Central Operations 518-402-4333 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities (Licence: NY 224141) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2015-12-28 |