Provider First Line Business Practice Location Address:
339 NORTH BROADWAY
Provider Second Line Business Practice Location Address:
THE SUMMIT SCHOOL AND CHILDREN'S RESIDENCE CENTER
Provider Business Practice Location Address City Name:
UPPER NYACK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-358-7772
Provider Business Practice Location Address Fax Number:
845-358-2487
Provider Enumeration Date:
10/01/2012