Provider Demographics
NPI:1861645855
Name:CHILDREN'S HOME INTERVENTION PROGRAM, INC.
Entity Type:Organization
Organization Name:CHILDREN'S HOME INTERVENTION PROGRAM, INC.
Other - Org Name:CHIP
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:MA, SAS
Authorized Official - Phone:718-984-9022
Mailing Address - Street 1:4300 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6505
Mailing Address - Country:US
Mailing Address - Phone:718-984-9022
Mailing Address - Fax:718-967-2073
Practice Address - Street 1:4300 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6505
Practice Address - Country:US
Practice Address - Phone:718-984-9022
Practice Address - Fax:718-967-2073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50700252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency