# SUSAN JOSEPH

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

## Provider details

- **NPI number:** 1801273222
- **Authorized official:** SUSAN JOSEPH (PRESIDENT)
- **Authorized official phone:** (516) 469-7955

## Contact information

- **Practice address:** 631 JENNINGS AVE, WEST HEMPSTEAD, NY 11552-3707
- **Practice address phone:** (516) 469-7955
- **Practice address fax:** (718) 247-5546
- **Mailing address:** 631 JENNINGS AVE, WEST HEMPSTEAD, NY 11552-3707
- **Mailing address phone:** (516) 469-7955
- **Mailing address fax:** (718) 247-5546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 094371-1 | NY | Yes |

## Other

- **Enumeration date:** 05/05/2015
- **Last updated:** 05/05/2015