| NPI | 1780316463 |
|---|---|
| Doing Business As | CCQP BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | ROBERT W MALIZIA Medical Director 315-362-5129 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |