IndividualActive
Jesse Brand
NPI 1013360361 · Emotionally Disturbed Childrens' Residential Treatment Facility · Shirley, NY
Provider details
- NPI number
- 1013360361
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
60 Forrest Ave
Shirley, NY 11967-1955
Phone: (631) 707-0190
Approximate (ZIP-level) locationGet directions
Mailing address
60 Forrest Ave
Shirley, NY 11967-1955
Registry dates
- Enumerated
- 2016-07-21
- Last updated
- 2016-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.