Individual provider · Type 1 NPI

Jennifer Keller

Physical Disabilities Residential Treatment Facility · Peconic, NY

NPI number 1578821385 Active

Practice location

1190 Arrowhead Ln
Peconic, NY 11958-1602

Mailing address

PO Box 436
Cutchogue, NY 11935-0436

Specialties and licenses

TaxonomyCodeLicense
Physical Disabilities Residential Treatment Facility Primary 320700000X494793 (NY)

Physical Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.

About NPI 1578821385

Jennifer Keller's National Provider Identifier is 1578821385, issued on Apr 30, 2012. The primary taxonomy on file is Physical Disabilities Residential Treatment Facility (320700000X), and the practice location is in Peconic, NY. The record was last updated on Apr 30, 2012.