Pierre L Licin

Individual provider Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1841443710

Pierre L Licin is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Babylon, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in: NY
In the registry since: 2008

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Practice location Address checks out

15 Eddie Ave
North Babylon, NY 11703-2712
Phone: (631) 586-2865

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Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary)	Taxonomy 320600000X · Licence 004355 (NY)

Record details

NPI number	1841443710
Entity type	Individual (Type 1)
Gender	Male
Sole proprietor	Yes
NPI enumerated	October 23, 2008
Last updated in NPPES	October 23, 2008
Mailing address	15 Eddie Ave, North Babylon, NY 11703-2712