# THERACARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063775310
- **Authorized official:** MISS IRIS N/A FUENTES I MSED (SPECIAL INSTRUCTOR)
- **Authorized official phone:** (718) 597-5558

## Contact information

- **Practice address:** 2510 WESTCHESTER AVE, 102, BRONX, NY 10461-3512
- **Practice address phone:** (718) 597-5558
- **Practice address fax:** (718) 823-5494
- **Mailing address:** 2510 WESTCHESTER AVENUE, 102, NEW YORK CITY, NY 10461-3512
- **Mailing address phone:** (718) 597-5558
- **Mailing address fax:** (718) 823-5494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 606668 | NY | Yes |

## Other

- **Enumeration date:** 06/21/2012
- **Last updated:** 06/21/2012