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Organization

ACHIEVEMENT FOR DISABLED YOUTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMAYLA ROSS (EXECUTIVE DIRECTOR)
(646) 824-3306
Entity
Organization

Contact information

Practice address
1090 UNIVERSITY AVE APT E3, BRONX, NY 10452-4219
(646) 824-3306
Mailing address
1090 UNIVERSITY AVE APT E3, BRONX, NY 10452-4219
(646) 824-3306

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
NY
302F00000X
Exclusive Provider Organization
NY
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
NY

Other

Enumeration date
01/09/2017
Last updated
01/09/2017
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