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Organization

INTERNATIONAL CENTER FOR THE DISABLED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS XIOMARA AMANDA MIGLIORINO CASAC (SUBSTANCE ABUSE COUNSELOR)
(212) 585-6221
Entity
Organization

Contact information

Practice address
340 E 24TH ST, SUITE 311, NEW YORK, NY 10010-4019
(212) 585-6221
Mailing address
237 W 115TH ST, APT 6A, NEW YORK, NY 10026-2900
(347) 500-0017

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
110110619
NY

Other

Enumeration date
10/26/2010
Last updated
10/26/2010
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