Provider Demographics
NPI:1497246110
Name:BLUE HORIZONS DAYCARE
Entity Type:Organization
Organization Name:BLUE HORIZONS DAYCARE
Other - Org Name:BLUE HORIZONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIR.
Authorized Official - Prefix:MS
Authorized Official - First Name:ABAIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-518-2873
Mailing Address - Street 1:15618 96TH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-2807
Mailing Address - Country:US
Mailing Address - Phone:917-518-2873
Mailing Address - Fax:718-338-4597
Practice Address - Street 1:15618 96TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2807
Practice Address - Country:US
Practice Address - Phone:917-518-2873
Practice Address - Fax:718-338-4597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY722350910OtherDRIVERS LIC.