Organization
BEANTOWN EARLY INTERVENTION SERVICES OF NY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCOS J RIVERA MSW (EXECUTIVE DIRECTOR)
(646) 642-6695
Entity
Organization
Contact information
Practice address
608 VAN NEST AVE, SUITE 1, BRONX, NY 10460-2709
(718) 824-3893
(718) 824-3893
Mailing address
608 VAN NEST AVE, SUITE 1, BRONX, NY 10460-2709
(718) 824-3893
(718) 824-3893
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
10/09/2016
Last updated
03/02/2017
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