Basic Information
| Provider Information | |||||||||
| NPI: | 1609362201 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CITIZENS OPTIONS UNLIMITED INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 189 WHEATLEY RD | ||||||||
| Address2: | |||||||||
| City: | GLEN HEAD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115452641 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 PORT WASHINGTON BLVD | ||||||||
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| City: | MANHASSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110301714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166261000 | ||||||||
| FaxNumber: | 5166263308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2018 | ||||||||
| LastUpdateDate: | 07/06/2018 | ||||||||
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| AuthorizedOfficialLastName: | REYES | ||||||||
| AuthorizedOfficialFirstName: | TERESA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ACCOUNTS REC SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 5166261000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310500000X | Y | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness |
No ID Information.