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General NPI Number Information
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NPI Number | 1043616212
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Entity Type | Organization
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Legal Business Name | LIFESTYLES FOR THE DISABLED, INC.
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Dates
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Enumeration Date | 11/14/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 930 WILLOWBROOK RD BUILDING 12G
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4209
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Country | US
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Telephone | 718-983-5351
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Fax | 718-983-5383
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Provider Business Mailing Address
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Address Line | 930 WILLOWBROOK RD BUILDING 12G
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4209
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Country | US
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Telephone | 718-983-5351
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Fax | 718-983-5383
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. SCOTT RICHARD SALINARDI
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Credential |
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Telephone | 718-983-5351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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