Organization
LIFELINE CENTER FOR CHILD DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA SIMON (EXECUTIVE DIRECTOR)
(631) 495-6486
Entity
Organization
Contact information
Practice address
8009 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2198
(631) 495-6486
Mailing address
8009 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2198
(631) 495-6486
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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