Provider First Line Business Practice Location Address:
INSTITUE FOR COMMUNITY LIVING, INC.
Provider Second Line Business Practice Location Address:
40 RECTOR STREET
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-855-7485
Provider Business Practice Location Address Fax Number:
718-855-1317
Provider Enumeration Date:
07/13/2007