NPI 1841333945

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Organisation Intellectual Disabilities Intermediate Care Facility Queens Village, NY

Practice location

Address: 21820 104th Ave, Queens Village, NY 11429-2051
Phone: (718) 776-4190
Mailing address: 191 Joralemon St 9th Floor, Brooklyn, NY 11201-4306

Authorised official

Name: Donna Corrado
Title: Executive Secretary
Phone: (718) 722-6123

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in New York →

Registry record

NPI: 1841333945
Entity type: Organization
NPI issued: 15 Feb 2007
Record last updated: 9 Jul 2008

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.