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Organization
UCPNYC
Active
Organization
UCPNYC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTHER M FENNIMORE (RN)
(718) 645-3125
Entity
Organization
Contact information
Practice address
175 LAWRENCE AVE, BROOKLYN, NY 11230-1102
(718) 436-7600
Mailing address
161 LAKE ST, BROOKLYN, NY 11223-2734
(718) 645-3125
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
226653
NY
Other
Enumeration date
05/07/2007
Last updated
02/19/2008
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