Organization
LIFE DOME ADULT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA KISSI MHP (EXECUTIVE DIRECTOR)
(347) 439-5772
Entity
Organization
Contact information
Practice address
716 E 224TH ST, BRONX, NY 10466-4206
(347) 439-5772
Mailing address
716 E 224TH ST, BRONX, NY 10466-4206
(347) 439-5772
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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