OrganizationActive
Epilepsy Foundation of Li
NPI 1205003647 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Hicksville, NY
Provider details
- NPI number
- 1205003647
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Elaine Lubelsky, Chief Financial Officer(516) 739-7733
- License
- 67510440 (NY)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 67510440 (NY)
Residential Treatment Facilities
Practice location
12 Violet Ave
Hicksville, NY 11801-1724
Phone: (516) 739-7733
Fax: (516) 739-1859
Approximate (ZIP-level) locationGet directions
Mailing address
506 Stewart Ave
Garden City, NY 11530-4706
Registry dates
- Enumerated
- 2008-05-14
- Last updated
- 2008-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.