| NPI | 1710159421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN PITRE Billing Supervisor 718-422-3229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |