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Organization

IMPULSE SUPPORT CARE LLC

Active
Other names
Family Therapy Care
Organization subpart
No

Provider details

NPI number
Authorized official
ANDRAE ALEXANDER GIVANS (CEO)
(917) 815-4455
Entity
Organization

Contact information

Practice address
295 MADISON AVE FL 12, NEW YORK, NY 10017-6379
(917) 815-4455
Mailing address
295 MADISON AVE FL 12, NEW YORK, NY 10017-6379
(917) 815-4455

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
09/14/2015
Last updated
09/14/2015
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