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General NPI Number Information
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NPI Number | 1891432431
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Entity Type | Organization
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Legal Business Name | OPEN MINDS EARLY CHILDHOOD PROGRAM INC.
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 24417 N CONDUIT AVE
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City | ROSEDALE
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State | NY
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Zip | 11422-2215
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Country | US
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Telephone | 718-341-0987
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Fax |
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Provider Business Mailing Address
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Address Line | 22919 MERRICK BLVD # 505
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City | LAURELTON
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State | NY
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Zip | 11413-2108
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OFFICER
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Name | MISS LAMARR R RIDDICK
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Credential |
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Telephone | 718-341-0987
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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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