Healthcare Provider Details

I. General information

NPI: 1982949194
Provider Name (Legal Business Name): PROGRAMA DEL ALMANECER PARA NINOS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 ZEISSNER LANE
SPRING VALLEY NY
10977
US

IV. Provider business mailing address

9 ZEISSNER LANE
SPRING VALLEY NY
10977
US

V. Phone/Fax

Practice location:
  • Phone: 845-262-1020
  • Fax:
Mailing address:
  • Phone: 845-262-1020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ROCHEL GOLDMAN
Title or Position: C.E.O.
Credential:
Phone: 845-262-1020