Provider Demographics
NPI:1932652518
Name:NICHOLAS CENTER
Entity Type:Organization
Organization Name:NICHOLAS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, CO-FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SUGRUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-767-7177
Mailing Address - Street 1:382 MAIN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3181
Mailing Address - Country:US
Mailing Address - Phone:516-767-7177
Mailing Address - Fax:
Practice Address - Street 1:382 MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3181
Practice Address - Country:US
Practice Address - Phone:516-767-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services