IndividualActive
Jacqueline Wilson
NPI 1336906064 · Emotionally Disturbed Childrens' Residential Treatment Facility · Pleasantville, NY
Provider details
- NPI number
- 1336906064
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
1075 Broadway
Pleasantville, NY 10570-2346
Phone: (914) 356-9333
Approximate (ZIP-level) locationGet directions
Mailing address
1075 Broadway
Pleasantville, NY 10570-2346
Registry dates
- Enumerated
- 2024-02-29
- Last updated
- 2024-02-29
- Certified
- 2024-02-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.