Healthcare Provider Details
I. General information
NPI: 1326752106
Provider Name (Legal Business Name): INCLUSIVE SERVICES FOR CHILDREN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2023
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
365 WEST 125TH STREET STE. 2A / UNIT 1489
NEW YORK NY
10027
US
IV. Provider business mailing address
2 W 129TH ST STE. 6B
NEW YORK NY
10027-2297
US
V. Phone/Fax
- Phone: 917-538-1584
- Fax:
- Phone: 917-538-1584
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAYI
NEUFELD
Title or Position: PRESIDENT /CEO
Credential: M.S.ED
Phone: 917-538-1584