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Organization

MARTIN DE PORRES SCHOOL FOR EXCEPTIONAL CHILDREN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAYMOND BLIXT (EXECUTIVE DIRECTOR)
(917) 596-5804
Entity
Organization

Contact information

Practice address
13625 218TH ST, SPRINGFIELD GARDENS, NY 11413-2226
(718) 525-3414
(718) 525-0986
Mailing address
13625 218TH ST, SPRINGFIELD GARDENS, NY 11413-2226
(718) 525-3414
(718) 525-0986

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
04/07/2010
Last updated
04/07/2010
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