| NPI | 1972049039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLA VOLCY Aed 718-965-1998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-02-15 |