Organization
PHOENIX EARLY INTERVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE CASCO (CEO)
(917) 231-5776
Entity
Organization
Contact information
Practice address
418 BROADWAY STE N, ALBANY, NY 12207-2922
(518) 241-6552
Mailing address
350 NORTHERN BLVD STE 324-1565, ALBANY, NY 12204-1000
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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