NPI 1750570495

Mission of the Immaculate

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Staten Island, NY

Practice location

Address: 6581 Hylan Blvd, Staten Island, NY 10309-3830
Phone: (718) 317-2803
Fax: (718) 317-2830

Authorised official

Name: Stephen W Rynn
Title: Executive Director
Phone: (718) 317-2803

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 7943430 (NY)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in New York →

Registry record

NPI: 1750570495
Entity type: Organization
NPI issued: 18 Oct 2007
Record last updated: 18 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.