Healthcare Provider Details

I. General information

NPI: 1841716099
Provider Name (Legal Business Name): PUZZLES AND PIECES BEHAVIORAL INTERVENTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W 1ST ST
WEST ISLIP NY
11795-2412
US

IV. Provider business mailing address

405 WEST 1ST ST
WEST ISLIP NY
11795
US

V. Phone/Fax

Practice location:
  • Phone: 516-637-0235
  • Fax:
Mailing address:
  • Phone: 516-637-0235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number001423-1
License Number StateNY

VIII. Authorized Official

Name: MELISSA HAGGERTY
Title or Position: FOUNDER, CEO
Credential: LBA., BCBA
Phone: 516-637-0235