| NPI | 1760694277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY ALLEN Owner 914-722-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 004559-1) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |