Provider Demographics
NPI:1063740033
Name:PARENT LEADERSHIP INSTITUTE ALUMNI ASSOCIATION, INC.
Entity type:Organization
Organization Name:PARENT LEADERSHIP INSTITUTE ALUMNI ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, CONSULTANT, FAC
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:718-276-4263
Mailing Address - Street 1:P.O. BOX 120310
Mailing Address - Street 2:118-09-195TH STREET
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-0310
Mailing Address - Country:US
Mailing Address - Phone:718-276-4263
Mailing Address - Fax:718-723-4993
Practice Address - Street 1:118-09-195TH STREET
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-3423
Practice Address - Country:US
Practice Address - Phone:718-276-4263
Practice Address - Fax:718-723-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty