| NPI | 1275927626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA C NWAOHUOCHA Licensed Nurse/Director 917-500-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NY 10301682) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 10301682) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2015-03-24 |