Provider Demographics
NPI:1285887356
Name:LITTLE SISTERS OF THE ASSUMPTION FAMILY HEALTH SERVICES
Entity type:Organization
Organization Name:LITTLE SISTERS OF THE ASSUMPTION FAMILY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:212-987-4422
Mailing Address - Street 1:333 EAST 115 ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10708
Mailing Address - Country:US
Mailing Address - Phone:212-987-4422
Mailing Address - Fax:
Practice Address - Street 1:333 E 115TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2210
Practice Address - Country:US
Practice Address - Phone:212-987-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14100252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14100OtherEARLY INTERVENTION PROGRAM CONTRACT NUMBER