| Elmhurst Hospital Center Supportive Case Management | |
|
7901 Broadway Suite D8 Elmhurst NY 11373-1329 | |
| (718) 334-4900 | |
| (718) 334-1026 |
| Full Name | Elmhurst Hospital Center Supportive Case Management |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7901 Broadway, Elmhurst, New York |
| Authorized Official Name and Position | Maxine J. Katz (ASSISTANT VICE PRESIDENT) |
| Authorized Official Contact | 6464583402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elmhurst Hospital Center Supportive Case Management 160 Water St Room 736 New York NY 10038-4922 Ph: (646) 458-3402 | Elmhurst Hospital Center Supportive Case Management 7901 Broadway Suite D8 Elmhurst NY 11373-1329 Ph: (718) 334-4900 |
| NPI Number | 1174642649 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 08/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174642649 | NPI | - | NPPES |
| 02209272 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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