| NPI | 1871978585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD A SEALS Executive Director 315-424-6080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |