Organization
EDUCERE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA FULKERSON (OWNER)
(516) 551-0120
Entity
Organization
Contact information
Practice address
3200 FALLING SPRINGS RD, BONNIEVILLE, KY 42713-7406
(516) 551-0120
Mailing address
3200 FALLING SPRINGS RD, BONNIEVILLE, KY 42713-7406
(516) 551-0120
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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