| NPI | 1295140663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIYA NAUMENKO President 917-463-6286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 252Y00000X Early Intervention Provider Agency | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |