Organization
BASIC BLOCKS THERAPEUTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAUSTINA YAWA ADZA (OCCUPATIONAL THERAPIST)
(845) 521-4373
Entity
Organization
Contact information
Practice address
7 MARINO BLVD, POMONA, NY 10970-3707
(845) 521-4373
Mailing address
7 MARINO BLVD, POMONA, NY 10970-3707
(845) 521-4373
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
014025-1
NY
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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