MEDICARE: MAKING HEADWAY FOUNDATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251X00000X	Supports Brokerage Agency
2	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1649043092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKING HEADWAY FOUNDATION INC

Provider Business Mailing Address
First Line	:	115 KING ST
Second Line	:
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3460
Country	:	US
Telephone Number	:	914-238-8384
Fax Number	:	914-238-1693

Provider Business Practice Location Address
First Line	:	115 KING ST
Second Line	:
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3460
Country	:	US
Telephone Number	:	914-238-8384
Fax Number	:	914-238-1693

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DANIEL LIPKA
Credential	:
Telephone Number	:	914-238-8384

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/06/2023

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Directions to “MAKING HEADWAY FOUNDATION INC ” Practice Location

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