Provider Demographics
NPI:1902242910
Name:KIDS ALTERNATIVE LEARNING & INTERVENTION SERVICES, LLC
Entity Type:Organization
Organization Name:KIDS ALTERNATIVE LEARNING & INTERVENTION SERVICES, LLC
Other - Org Name:POSITIVE HORIZON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINIQUE-MCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:917-518-2873
Mailing Address - Street 1:88 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-3811
Mailing Address - Country:US
Mailing Address - Phone:917-518-2873
Mailing Address - Fax:631-399-5833
Practice Address - Street 1:88 MADISON ST
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-3811
Practice Address - Country:US
Practice Address - Phone:917-518-2873
Practice Address - Fax:631-399-5833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency