| NPI | 1831886761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANTONICK Clinical Director 518-669-1798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2023-07-10 |