| NPI | 1952057051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLINE ETIENNE Director 718-701-1586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 174200000X Meals |
| 251300000X Local Education Agency (LEA) | |
| 251K00000X Public Health or Welfare | |
| 251T00000X PACE Provider Organization | |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-02-28 |