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
| Taxonomy | Code | License |
|---|---|---|
| Physical Disabilities Residential Treatment Facility Primary | 320700000X | 494793 (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.