| NPI | 1922496926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BRADLEY FUNK Physical Therapist Assistant 518-320-5715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC 5480) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |