# FAMILY SERVICE LEAQUE

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

## Provider details

- **NPI number:** 1275149619
- **Authorized official:** NIRVA MELLISA PIERRE RN (REGISTERED NURSE)
- **Authorized official phone:** (347) 453-9477

## Contact information

- **Practice address:** 790 PARK AVE, HUNTINGTON, NY 11743-4516
- **Practice address phone:** (631) 470-6788
- **Practice address fax:** (631) 427-4268
- **Mailing address:** 790 PARK AVE, HUNTINGTON, NY 11743-4516
- **Mailing address phone:** (631) 470-6788
- **Mailing address fax:** (631) 427-4268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | — |

## Other

- **Enumeration date:** 09/21/2020
- **Last updated:** 09/21/2020