Organization
SUSAN JOSEPH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN JOSEPH (PRESIDENT)
(516) 469-7955
Entity
Organization
Contact information
Practice address
631 JENNINGS AVE, WEST HEMPSTEAD, NY 11552-3707
(516) 469-7955
(718) 247-5546
Mailing address
631 JENNINGS AVE, WEST HEMPSTEAD, NY 11552-3707
(516) 469-7955
(718) 247-5546
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
094371-1
NY
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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