Provider Demographics
NPI:1053547307
Name:INFANT TODDLER SERVICE COORDINATORS, LLC
Entity type:Organization
Organization Name:INFANT TODDLER SERVICE COORDINATORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:SHERYL
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:845-255-2121
Mailing Address - Street 1:30 OUTLOOK DR
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3617
Mailing Address - Country:US
Mailing Address - Phone:845-255-2121
Mailing Address - Fax:845-255-1177
Practice Address - Street 1:30 OUTLOOK DR
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-3617
Practice Address - Country:US
Practice Address - Phone:845-255-2121
Practice Address - Fax:845-255-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency