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Organization

THERACARE

Active
Other names
Therecare
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CARLOTA POWELL VASQUEZ II SPECIAL ED. TEACHER (SPECIAL ED. TEACHER)
(347) 856-2646
Entity
Organization

Contact information

Practice address
171 RANDOLPH AVE, 171 RANDOLPH AVE, JERSEY CITY, NJ 07305-4416
(347) 856-2646
Mailing address
171 RANDOLPH AVE, 171 RANDOLPH AVE, JERSEY CITY, NJ 07305-4416
(347) 856-2646

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
56062
NY

Other

Enumeration date
06/12/2012
Last updated
06/12/2012
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