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General NPI Number Information
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NPI Number | 1306260096
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Entity Type | Organization
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Legal Business Name | WEST ISLIP YOUTH ENRICHMENT SERVICES INCORPORATED
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 401 MAIN ST SUITE #108
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City | ISLIP
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State | NY
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Zip | 11751-3560
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Country | US
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Telephone | 631-446-1950
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Fax | 631-446-1952
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Provider Business Mailing Address
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Address Line | PO BOX 105
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City | WEST ISLIP
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State | NY
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Zip | 11795-0105
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Country | US
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Telephone | 631-587-5172
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Fax | 631-661-2973
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MARYANN PFEIFFER
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Credential |
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Telephone | 631-587-5172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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