Organization
TRANSITIONAL SERVICE OF NY FOR LI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUNO LA SPINA (CHIEF EXECUTIVE OFFICER)
(631) 231-3619
Entity
Organization
Contact information
Practice address
840 SUFFOLK AVE, BRENTWOOD, NY 11717-4404
(631) 231-3619
(631) 231-4754
Mailing address
840 SUFFOLK AVE, BRENTWOOD, NY 11717-4404
(631) 231-3619
(631) 231-4754
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
01304530
NY
Other
Enumeration date
03/14/2007
Last updated
05/19/2009
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