Provider Demographics
NPI:1669626503
Name:UNITED CEREBRAL PALSY OF QUEENS
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF QUEENS
Other - Org Name:QUEENS CENTERS FOR PROGRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-380-3000
Mailing Address - Street 1:8115 164TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1118
Mailing Address - Country:US
Mailing Address - Phone:718-380-3000
Mailing Address - Fax:
Practice Address - Street 1:8225 164TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1120
Practice Address - Country:US
Practice Address - Phone:718-374-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency