| NPI | 1700033149 |
|---|---|
| Other Name | HOME BASED COMMUNITY WAIVER PROGRAM |
| Entity Type | Organization |
| Authorized Contact | ROBERT ROTH Billing/Credentialing Mgr. 516-746-0350 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2021-11-23 |