# EARLY CHILDHOOD INTERVENTION SERVICES

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

## Provider details

- **NPI number:** 1770892853
- **Authorized official:** PAULA SIMS (DIRECTOR)
- **Authorized official phone:** (718) 344-4508

## Contact information

- **Practice address:** 14483 176TH ST, JAMAICA, NY 11434-4913
- **Practice address phone:** (718) 977-0110
- **Mailing address:** 14483 176TH ST, JAMAICA, NY 11434-4913
- **Mailing address phone:** (718) 977-0110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 58014667 | NY | Yes |
| 305S00000X | Point of Service | 58-017019 | NY | — |

## Other

- **Enumeration date:** 10/06/2010
- **Last updated:** 10/06/2010