Bustamonte Residence
NPI #1134240831 in West Babylon, New York
Provider Information
- NPI Number
- 1134240831
- Entity Type
- Organization
- Organization Name
- Bustamonte Residence
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Apr 2, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 664 ALBIN AVE
- City
- West Babylon
- State
- New York
- ZIP Code
- 11704-7402
- Phone
- (631) 665-3434
Authorized Official
- Name
- EDWIN M KENNEDY
- Title
- CFO
- Phone
- (516) 733-7000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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