| NPI | 1861604613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL WHITE Reimbursement Specialist 716-886-2137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 070510718) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |