Individual provider · Type 1 NPI
Jesse Brand
Emotionally Disturbed Childrens' Residential Treatment Facility · Shirley, NY
NPI number
1013360361
Active
Practice location
60 Forrest Ave
Shirley, NY 11967-1955
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | None listed |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
About NPI 1013360361
Jesse Brand's National Provider Identifier is 1013360361, issued on Jul 21, 2016. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Shirley, NY. The record was last updated on Jul 21, 2016.