Organization
THERACARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA VELASQUEZ (SERVICE COORDINATOR)
(646) 434-8030
Entity
Organization
Contact information
Practice address
9777 QUEENS BLVD, PENTHOUSE, REGO PARK, NY 11374-3335
(718) 830-9274
Mailing address
8405 108TH ST, B2, RICHMOND HILL, NY 11418-1200
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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