Organization
CAROL LOURDES CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELSIE M RENTA MS. ED. (PRESIDENT)
(917) 478-8417
Entity
Organization
Contact information
Practice address
6125 98TH ST, APT. 16H, REGO PARK, NY 11374-1419
(917) 478-8417
Mailing address
PO BOX 103, LAKE ARIEL, PA 18436-0103
(917) 478-8417
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1846740
NY
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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