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Organization
TEACHING FAMILY MANORVILLE
Active
Organization
TEACHING FAMILY MANORVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN M KENNEDY (CFO)
(516) 733-7000
Entity
Organization
Contact information
Practice address
416 WEEKS AVE, MANORVILLE, NY 11949-2036
(631) 878-1320
Mailing address
416 WEEKS AVE, MANORVILLE, NY 11949-2036
(631) 878-1320
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01303497
—
NY
Enumeration date
04/03/2007
Last updated
08/22/2020
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