# SERVICES FOR THE UNDERSERVED

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

## Provider details

- **NPI number:** 1437322062
- **Authorized official:** LYNETTE BACCHUS (AR SUPERVISOR)
- **Authorized official phone:** (917) 408-1611

## Contact information

- **Practice address:** 305 7TH AVE, NEW YORK, NY 10001-6008
- **Practice address phone:** (917) 408-1611
- **Mailing address:** 305 7TH AVE, NEW YORK, NY 10001-6008
- **Mailing address phone:** (917) 408-1611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/03/2008
- **Last updated:** 04/03/2008