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General NPI Number Information
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NPI Number | 1558845271
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Entity Type | Organization
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Legal Business Name | SPECIAL LIVES, INC.
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 15 SHEARWATER WAY
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City | CENTEREACH
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State | NY
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Zip | 11720-4313
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Country | US
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Telephone | 631-820-1984
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SHEARWATER WAY
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City | CENTEREACH
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State | NY
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Zip | 11720-4313
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Country | US
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Telephone | 631-820-1984
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DANA MARIE PLANZ
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Credential | MSED
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Telephone | 631-820-1984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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