Organization
THERACARE
Active
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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