Intensive Case Management Program

NPI #1649481219 in Brentwood, New York

Provider Information

NPI Number: 1649481219
Entity Type: Organization
Organization Name: Intensive Case Management Program
Primary Specialty: Case Management
Enumeration Date: May 25, 2007
Last Updated: Oct 17, 2007

Practice Location

Address: 1841 BRENTWOOD RD
City: Brentwood
State: New York
ZIP Code: 11717-4625
Phone: (631) 853-2762

Authorized Official

Name: DOREEN DESMOND, LCSW
Title: CASE MANAGER
Phone: (631) 853-2762

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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