Organization
LITTLE VILLAGE HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARYL BANK (DIRECTOR)
(516) 520-6003
Entity
Organization
Contact information
Practice address
150 PORT WASHINGTON BLVD, MANHASSET, NY 11030-1714
(516) 365-4480
(516) 365-4438
Mailing address
750 HICKSVILLE RD, SEAFORD, NY 11783-1328
(516) 520-6000
(516) 520-6080
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01102809
—
NY
Enumeration date
02/07/2007
Last updated
08/22/2020
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