Healthcare Provider Details

I. General information

NPI: 1912134461
Provider Name (Legal Business Name): SIMPLY SPECIAL EARLY LEARNING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 5TH AVE
FRANKFORT NY
13340-3622
US

IV. Provider business mailing address

325 5TH AVE
FRANKFORT NY
13340-3622
US

V. Phone/Fax

Practice location:
  • Phone: 315-894-3056
  • Fax: 315-895-0062
Mailing address:
  • Phone: 315-894-3056
  • Fax: 315-895-0062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. GEORGIANNE T. SNELL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 315-894-3056