| NPI | 1780725069 |
|---|---|
| Former Legal Business Name | SUPERVISED LIFESTYLES SIS HEALTH |
| Entity Type | Organization |
| Authorized Contact | BETSY BERGMAN Administrator CFO 845-279-5994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: NY 8490002) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |