| NPI | 1871279356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW COUCH President 585-880-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-06-27 |