| NPI | 1336309954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASSHEVY MILLER Cpa Com PT Roller 718-875-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2008-06-17 |