| NPI | 1821768367 |
|---|---|
| Other Name | TACONIC DDSO |
| Entity Type | Organization |
| Authorized Contact | EARL RAYMOND JEFFERSON Director Of Central Operations 518-402-4333 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |