Organization
LIFE'S WORC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PEG BARRY (ACCOUNTANT)
(516) 741-9000
Entity
Organization
Contact information
Practice address
179-49 N. CONDUIT AVE, SPRINGFIELD GARDENS, NY 11413
(718) 527-5307
(718) 527-3020
Mailing address
1501 FRANKLIN AVE, GARDEN CITY, NY 11530-8165
(516) 741-9000
(516) 302-1802
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
7075443
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02252793
—
NY
Enumeration date
01/26/2007
Last updated
08/22/2020
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