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Organization

SPECIALIZED ORGANIZATION FOR DISABILITIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS TIFFANY DACRE M.S (CEO)
(347) 489-5207
Entity
Organization

Contact information

Practice address
304 E 54TH ST, BROOKLYN, NY 11203-4602
(347) 489-5207
Mailing address
304 E 54TH ST, BROOKLYN, NY 11203-4602
(347) 489-5207

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
337712658
NY
252Y00000X
Early Intervention Provider Agency
337712658
NY

Other

Enumeration date
09/13/2016
Last updated
09/13/2016
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