Provider Demographics
NPI:1912134461
Name:SIMPLY SPECIAL EARLY LEARNING CENTER LLC
Entity Type:Organization
Organization Name:SIMPLY SPECIAL EARLY LEARNING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGIANNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-894-3056
Mailing Address - Street 1:325 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-3622
Mailing Address - Country:US
Mailing Address - Phone:315-894-3056
Mailing Address - Fax:315-895-0062
Practice Address - Street 1:325 5TH AVE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:NY
Practice Address - Zip Code:13340-3622
Practice Address - Country:US
Practice Address - Phone:315-894-3056
Practice Address - Fax:315-895-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY22808OtherEI AGENCY PROVIDER