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Organization
MEDICAID
Active
Organization
MEDICAID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANUELLA SILNE ALLONCE (LICENSE PRACTICAL NURSE)
(516) 812-7614
Entity
Organization
Contact information
Practice address
329 W JAMAICA AVE, VALLEY STREAM, NY 11580-5322
(516) 812-7614
Mailing address
329 W JAMAICA AVE, VALLEY STREAM, NY 11580-5322
(516) 812-7614
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
265009
NY
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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