| NPI | 1003015694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYNELL BROWN Fiscal Administrator 718-422-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 251S00000X | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2022-07-21 |