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Organization

CHILDREN SERVICES BROADEN, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHIRLEY SIMS MSED (SPECIAL INSTRUCTOR)
(631) 743-0159
Entity
Organization

Contact information

Practice address
1838 CHOWAN ST, ELMONT, NY 11003-1741
(631) 743-0159
Mailing address
PO BOX 30633, ELMONT, NY 11003-0633
(347) 515-9014

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
05/29/2019
Last updated
05/29/2019
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