| NPI | 1851063606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KASSEL Credentialing Cooridnator 315-472-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2021-09-30 |