Provider Demographics
NPI:1679745913
Name:TERAPRO. CARE
Entity Type:Organization
Organization Name:TERAPRO. CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:BENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-249-5884
Mailing Address - Street 1:PO BOX 30088
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-0088
Mailing Address - Country:US
Mailing Address - Phone:718-404-2185
Mailing Address - Fax:
Practice Address - Street 1:2717 SCHLEIGEL BLVD
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-1345
Practice Address - Country:US
Practice Address - Phone:718-404-2185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0089371320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities