Provider Demographics
NPI:1730485756
Name:CENTER FOR SOCIAL ENRICHMENT AND EDUCATIONAL DEVELOPMENT, LLC
Entity Type:Organization
Organization Name:CENTER FOR SOCIAL ENRICHMENT AND EDUCATIONAL DEVELOPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHERMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:203-674-8200
Mailing Address - Street 1:30 BUXTON FARM RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1224
Mailing Address - Country:US
Mailing Address - Phone:203-674-8200
Mailing Address - Fax:203-674-8202
Practice Address - Street 1:30 BUXTON FARM RD
Practice Address - Street 2:SUITE 105
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1224
Practice Address - Country:US
Practice Address - Phone:203-674-8200
Practice Address - Fax:203-674-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116640503251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health