Organization · NPI-2

820 River Street

Community/Behavioral Health · Jamaica, NY

NPI number1588077655
StatusActive
Last updated in NPPESJun 6, 2014

Details

NPI
1588077655
Entity type
Organization (NPI-2)
Legal business name
820 River Street
Organization subpart
No
Enumeration date
Jun 6, 2014
Last updated
Jun 6, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health–NYYes

Practice location

10830 Sutphin Blvd
Jamaica, NY 11435-5444

Phone 718-526-3803 · Fax 718-526-3908

Mailing address

10830 Sutphin Blvd
Jamaica, NY 11435-5444

Phone 718-526-3803 · Fax 718-526-3908

Authorized official

Elizabeth Vasquez
Ofice Manager
7185263803

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