| NPI | 1871038901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAROD MASCI Owner 716-462-8871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NY 264173) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2016-12-28 |