# IMPULSE SUPPORT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Therapy Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023486511
- **Authorized official:** ANDRAE ALEXANDER GIVANS (CEO)
- **Authorized official phone:** (917) 815-4455

## Contact information

- **Practice address:** 295 MADISON AVE FL 12, NEW YORK, NY 10017-6379
- **Practice address phone:** (917) 815-4455
- **Mailing address:** 295 MADISON AVE FL 12, NEW YORK, NY 10017-6379
- **Mailing address phone:** (917) 815-4455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/14/2015
- **Last updated:** 09/14/2015