| NPI | 1821238486 |
|---|---|
| Doing Business As | BLACK ICE PRO |
| Entity Type | Organization |
| Authorized Contact | ANDRE M GIBSON Manger 347-240-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: NY 071465614) |
| Additional Taxonomies | 284300000X Special Hospital |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2009-02-23 |