| NPI | 1821396987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN D LEMERY Clinical Social Worker 518-307-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 069364-1) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2011-06-20 |