Provider Demographics
NPI:1154704799
Name:RAC BIRTH TO THREE
Entity type:Organization
Organization Name:RAC BIRTH TO THREE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-332-4363
Mailing Address - Street 1:1931 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3506
Mailing Address - Country:US
Mailing Address - Phone:203-332-4363
Mailing Address - Fax:203-384-0956
Practice Address - Street 1:1931 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3506
Practice Address - Country:US
Practice Address - Phone:203-332-4363
Practice Address - Fax:203-384-0956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHABILITATION ASSOCIATES OF CT., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency