| NPI | 1255503421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BENENATI Controller 718-422-2204 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2022-07-21 |