Provider Demographics
NPI:1023857281
Name:REPAIR THE WORLD CHILD BY CHILD
Entity type:Organization
Organization Name:REPAIR THE WORLD CHILD BY CHILD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMPTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-874-9878
Mailing Address - Street 1:1755 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570
Mailing Address - Country:US
Mailing Address - Phone:845-874-9878
Mailing Address - Fax:
Practice Address - Street 1:1755 BROADWAY
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570
Practice Address - Country:US
Practice Address - Phone:845-874-9878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management