Organization
TLC KIDS THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GOUVEIA OTR/L (OCCUPATIONAL THERAPIST/OWNER)
(516) 345-8992
Entity
Organization
Contact information
Practice address
3270 MARK ALAN DR, WANTAGH, NY 11793-1841
(516) 287-4419
Mailing address
3270 MARK ALAN DR, WANTAGH, NY 11793-1841
(516) 287-4419
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
011216-1
NY
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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