Individual provider · Type 1 NPI

Agnes Alexis

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Elmont, NY

NPI number 1669078705 Active

Practice location

40 Elmont Rd
Elmont, NY 11003-1603

Call (347) 542-5644 Map

Mailing address

14202 20th Ave
Flushing, NY 11351-3000

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1669078705

Agnes Alexis's National Provider Identifier is 1669078705, issued on Dec 4, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Elmont, NY. The record was last updated on Dec 4, 2020.