Mission of the Immaculate
NPI #1750570495 in Staten Island, New York
Provider Information
- NPI Number
- 1750570495
- Entity Type
- Organization
- Organization Name
- Mission of the Immaculate
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Oct 18, 2007
- Last Updated
- Oct 18, 2007
Practice Location
- Address
- 6581 HYLAN BLVD
- City
- Staten Island
- State
- New York
- ZIP Code
- 10309-3830
- Phone
- (718) 317-2803
Authorized Official
- Name
- MR. STEPHEN W RYNN
- Title
- EXECUTIVE DIRECTOR
- Phone
- (718) 317-2803
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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