Provider Demographics
NPI:1184103137
Name:EMINEM CARE INC.
Entity type:Organization
Organization Name:EMINEM CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ED
Authorized Official - Prefix:
Authorized Official - First Name:MAGALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-656-0474
Mailing Address - Street 1:872 PARK LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2713
Mailing Address - Country:US
Mailing Address - Phone:917-656-0474
Mailing Address - Fax:
Practice Address - Street 1:872 PARK LN
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-2713
Practice Address - Country:US
Practice Address - Phone:917-656-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency