Provider Demographics
NPI:1174733539
Name:SOUTH SHORE ASOCIATION FOR INDEPENDENT LIVING, INC.
Entity type:Organization
Organization Name:SOUTH SHORE ASOCIATION FOR INDEPENDENT LIVING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VEZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-855-1800
Mailing Address - Street 1:1976 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2813
Mailing Address - Country:US
Mailing Address - Phone:516-855-1800
Mailing Address - Fax:516-855-1811
Practice Address - Street 1:1976 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:516-855-1800
Practice Address - Fax:516-855-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty