| NPI | 1073133682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS ADDO Executive Director 347-687-7701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |