| NPI | 1578843975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA MCDONALD Aed 718-789-7539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: NY 315P00000X) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-08-17 |