# FUNCTIONAL LIFE ACHIEVEMENT

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

## Provider details

- **NPI number:** 1548544620
- **Authorized official:** PHYLLIS PARISI-ELLIS (ED SUPERVISOR)
- **Authorized official phone:** (718) 886-6456

## Contact information

- **Practice address:** 161 MADISON AVE, 2ND FLOOR, NEW YORK, NY 10016-5421
- **Practice address phone:** (212) 683-8905
- **Mailing address:** 161 MADISON AVE, 2ND FLOOR, NEW YORK, NY 10016-5421
- **Mailing address phone:** (212) 683-8905

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 2305418 | NY | Yes |

## Other

- **Enumeration date:** 10/06/2011
- **Last updated:** 10/06/2011