Provider Demographics
NPI:1366206575
Name:TRUE CARE OF LONG ISLAND LLC
Entity type:Organization
Organization Name:TRUE CARE OF LONG ISLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-420-6900
Mailing Address - Street 1:71 BIRCHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-1249
Mailing Address - Country:US
Mailing Address - Phone:646-420-6900
Mailing Address - Fax:
Practice Address - Street 1:71 BIRCHWOOD RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-1249
Practice Address - Country:US
Practice Address - Phone:646-420-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency