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Organization

THERACARE

Active
Parent organization
THERACARE
Organization subpart
Yes

Provider details

NPI number
Legal business name
THERACARE
Authorized official
MS. TRECIA A KELLOGG LMSW (ABA SERVICE PROVIDER)
(914) 450-2399
Entity
Organization

Contact information

Practice address
3250 WESTCHESTER AVE RM 108, BRONX, NY 10461-4548
(718) 597-5558
Mailing address
115 LAWTON ST APT 5H, YONKERS, NY 10705-4636
(914) 450-2399

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
72070938
NY

Other

Enumeration date
03/02/2012
Last updated
03/02/2012
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