Organization
KIDS PLAY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XERISS JOANAH SANTA ANA OTR/L (OCCUPATIONAL THERAPIST)
(917) 822-6461
Entity
Organization
Contact information
Practice address
209 MURRAY AVE, GOSHEN, NY 10924-1205
(917) 822-6461
Mailing address
209 MURRAY AVE, GOSHEN, NY 10924-1205
(917) 822-6461
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
008688-1
NY
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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