Provider First Line Business Practice Location Address:
590 SHEFFIELD STREET
Provider Second Line Business Practice Location Address:
INSTITUTE FOR COMMUNITY LIVING, INC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11207-6310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-385-3030
Provider Business Practice Location Address Fax Number:
718-485-4018
Provider Enumeration Date:
04/13/2009