Organization
THERACARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA ANN FAIX (ABA THERAPIST)
(718) 239-1048
Entity
Organization
Contact information
Practice address
1160 THROGGMORTON AVE, BRONX, NY 10465-1429
(718) 239-1048
Mailing address
1160 THROGGMORTON AVE, BRONX, NY 10465-1429
(718) 239-1048
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
700656
NY
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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