| NPI | 1083371330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH ANNOR Socail Worker 347-247-6650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 251X00000X Supports Brokerage | |
| 253Z00000X In Home Supportive Care | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385HR2050X Respite Care, Respite Care Camp | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2021-11-22 |