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General NPI Number Information
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NPI Number | 1922241132
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Entity Type | Organization
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Legal Business Name | LIFE CYCLE RESURCES, INC.
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 6625 103RD ST APT 6H
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City | FOREST HILLS
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State | NY
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Zip | 11375-2021
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Country | US
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Telephone | 718-406-9486
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Fax | 718-897-4980
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Provider Business Mailing Address
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Address Line | 6625 103RD ST APT 6H
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City | FOREST HILLS
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State | NY
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Zip | 11375-2021
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Country | US
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Telephone | 718-406-9486
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Fax | 718-897-4980
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | SARA MEISEL
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Credential | CCC-SLP
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Telephone | 917-697-6565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 422
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License Number State | NY
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