Organization
LIFELONG THERAPUTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY CIOLINO OTR/L (OWNER)
(631) 385-2411
Entity
Organization
Contact information
Practice address
337 DEER PARK RD, DIX HILLS, NY 11746-5203
(631) 385-2411
(631) 385-2411
Mailing address
143 CHARDONNAY DR, EAST QUOGUE, NY 11942-3829
(631) 385-2411
(631) 385-2411
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
2595
NY
Other
Enumeration date
01/07/2008
Last updated
01/07/2008
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