| Head Start | |
|
6002 Roosevelt Ave Woodside NY 11377-3538 | |
| (718) 943-2800 | |
| (718) 943-2799 |
| Full Name | Head Start |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 6002 Roosevelt Ave, Woodside, New York |
| Authorized Official Name and Position | Jean M Coppola (BILLING MANAGER) |
| Authorized Official Contact | 7186517770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Head Start 6002 Queens Blvd Woodside NY 11377-4973 Ph: (718) 651-7770 | Head Start 6002 Roosevelt Ave Woodside NY 11377-3538 Ph: (718) 943-2800 |
| NPI Number | 1134399108 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 08/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134399108 | NPI | - | NPPES |
| 00244371 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 6734121C (New York) | Primary |
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