| Emmas Place-staten Island Grief And Loss Center For Children And Famil | |
|
1000 Richmond Ter # D Staten Island NY 10301-1114 | |
| (347) 850-2322 | |
| Not Available |
| Full Name | Emmas Place-staten Island Grief And Loss Center For Children And Famil |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1000 Richmond Ter # D, Staten Island, New York |
| Authorized Official Name and Position | Matthew Raymond Kiefer (BOARD SECRETARY) |
| Authorized Official Contact | 8454539690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emmas Place-staten Island Grief And Loss Center For Children And Famil Po Box 10311 Staten Island NY 10301-0311 Ph: (845) 453-9690 | Emmas Place-staten Island Grief And Loss Center For Children And Famil 1000 Richmond Ter # D Staten Island NY 10301-1114 Ph: (347) 850-2322 |
| NPI Number | 1184337404 |
|---|---|
| Provider Enumeration Date | 01/02/2023 |
| Last Update Date | 01/02/2023 |
| Certification Date | 01/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184337404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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