| NPI | 1407359482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA ESTERKINA Si/Aba Provider 718-614-0702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-20 |