Organization
JUST KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PENNEY R OBRIEN REGISTERED NURSE (REGISTERED NURSE)
(631) 708-8403
Entity
Organization
Contact information
Practice address
2111 AVALON PINES DR, CORAM, NY 11727-5146
(631) 708-8403
Mailing address
2111 AVALON PINES DR, CORAM, NY 11727-5146
(631) 708-8403
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
475564
NY
Other
Enumeration date
06/20/2013
Last updated
06/20/2013
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