| NPI | 1801007364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DUVALL CEO Administrator 315-519-5201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 2238001H) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-12-30 |