Self Initiated Living Options INC

NPI #1558139709 in Medford, New York

Provider Information

NPI Number: 1558139709
Entity Type: Organization
Organization Name: Self Initiated Living Options INC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Dec 18, 2023
Last Updated: Dec 18, 2023

Practice Location

Address: 3245 ROUTE 112 STE 1
City: Medford
State: New York
ZIP Code: 11763-1441
Phone: (631) 880-7929

Authorized Official

Name: LAURIE DELGADO
Title: AM
Phone: (631) 880-7929

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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