NPI 1114304458

Sus

Organisation Substance Abuse Rehabilitation Facility New York, NY

Practice location

Address: 170 E 107th St, New York, NY 10029-3905
Phone: (212) 722-7507
Fax: (212) 722-7583

Authorised official

Name: Laura Wierbicki
Title: Program Manager
Phone: (212) 722-7507

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 150511551 (NY)

Other Substance Abuse Rehabilitation Facility providers in New York →

Registry record

NPI: 1114304458
Entity type: Organization
NPI issued: 6 May 2015
Record last updated: 6 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.