Organization
INDIVIDUALIZED FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOCHEVED POLISHUK MS (OWNER/PRACTICE MANAGER)
(347) 369-2733
Entity
Organization
Contact information
Practice address
12-22 30TH AVE, APT 4H, ASTORIA, NY 11102
(347) 369-2733
Mailing address
12-22 30TH AVE, 4 H, ASTORIA, NY 11102
(347) 369-2733
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/19/2016
Last updated
06/20/2016
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