# CHILD PRO

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

## Provider details

- **NPI number:** 1982967113
- **Authorized official:** MRS. MICHELE ELIZABETH ALLEN MSED. (SPECIAL EDUCATION TEACHER)
- **Authorized official phone:** (716) 646-1264

## Contact information

- **Practice address:** 697 RIDGE RD, LACKAWANNA, NY 14218-1500
- **Practice address phone:** (716) 822-4781
- **Mailing address:** 697 RIDGE RD, LACKAWANNA, NY 14218-1500
- **Mailing address phone:** (716) 822-4781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 208888081 | NY | Yes |

## Other

- **Enumeration date:** 06/21/2012
- **Last updated:** 06/21/2012