| NPI | 1891104113 |
|---|---|
| Other Name | NOT IN USE |
| Entity Type | Organization |
| Authorized Contact | LINDSAY HERNDON CEO 716-314-5903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2023-05-23 |