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Pierre L Licin
Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Babylon, New York
NPI 1841443710

Pierre L Licin is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in North Babylon, NY. Pierre L Licin practices in North Babylon, NY. The NPI Number for Pierre L Licin is 1841443710 and holds a License No. 004355 (New York).

The current practice location address for Pierre L Licin is 15 Eddie Ave, North Babylon, NY and can be reached out via phone at 631-586-2865.

Location: 15 Eddie Ave, North Babylon, NY, 11703-2712
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841443710
Provider Name
Pierre L Licin
Credential
Provider Entity Type
Individual
Gender
Male
Address
15 Eddie Ave, North Babylon, NY, 11703-2712
Phone Number
631-586-2865
Fax Number
Provider Enumeration Date
10/23/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
15 Eddie Ave
City
North Babylon
State
New York
Zip
11703-2712
Phone Number
631-586-2865
Fax Number
person
Provider Business Mailing Address Details
Address
15 Eddie Ave
City
North Babylon
State
New York
Zip
11703-2712
Phone Number
631-586-2865
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
004355 (New York)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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