Organization
UNITED CEREBRAL PALSY ASSOCIATION OF GREATER SUFFOLK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANINE KLEIN (CFO)
(631) 232-0011
Entity
Organization
Contact information
Practice address
39 LAKESIDE AVE, LAKE GROVE, NY 11755-1801
(631) 232-0011
Mailing address
250 MARCUS BLVD, HAUPPAUGE, NY 11788-2018
(631) 232-0011
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00692842
—
NY
Enumeration date
02/14/2007
Last updated
07/21/2015
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