Provider Demographics
NPI:1295273258
Name:GENTLE CARE
Entity type:Organization
Organization Name:GENTLE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION TEACHER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAFIYA
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:MSSPED
Authorized Official - Phone:917-676-6388
Mailing Address - Street 1:196 STUYVESANT AVE
Mailing Address - Street 2:APT. 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-1815
Mailing Address - Country:US
Mailing Address - Phone:917-676-6388
Mailing Address - Fax:
Practice Address - Street 1:196 STUYVESANT AVE
Practice Address - Street 2:APT. 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1815
Practice Address - Country:US
Practice Address - Phone:917-676-6388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1267629252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency