National Provider Identifier Database

JUST KIDS
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

JUST KIDS
2111 AVALON PINES DR
CORAM, NY11727-5146
Phone: 631-708-8403
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for JUST KIDS

NPI Number 1548609803
Legal business name
LBN
JUST KIDS
Authorized official PENNEY OBRIEN - (REGISTERED NURSE)
Entity Organization
Organization subpart No
Enumeration date 06/20/2013
Last updated 06/20/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 475564

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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