| NPI | 1912523929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A FOGEL Owner 585-474-0356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2023-04-13 |