| Revcore Recovery Center Of Manhattan, Llc | |
|
15 2nd Ave Fl 3 Brooklyn NY 11215-2711 | |
| (718) 514-6007 | |
| Not Available |
| Full Name | Revcore Recovery Center Of Manhattan, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15 2nd Ave Fl 3, Brooklyn, New York |
| Authorized Official Name and Position | Avraham Schick (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2129669537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revcore Recovery Center Of Manhattan, Llc 15 2nd Ave Fl 3 Brooklyn NY 11215-2711 Ph: () - | Revcore Recovery Center Of Manhattan, Llc 15 2nd Ave Fl 3 Brooklyn NY 11215-2711 Ph: (718) 514-6007 |
| NPI Number | 1154094555 |
|---|---|
| Provider Enumeration Date | 07/30/2021 |
| Last Update Date | 07/30/2021 |
| Certification Date | 07/30/2021 |
| Medicare PECOS PAC ID | 7517344278 |
|---|---|
| Medicare Enrollment ID | O20220518001475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154094555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Michelle M Knapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104267061 PECOS PAC ID: 2769700384 Enrollment ID: I20150410002075 |
| Provider Name | Abigail B Strubel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568792158 PECOS PAC ID: 8820363781 Enrollment ID: I20171004000177 |
| Provider Name | Lisa D White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073674321 PECOS PAC ID: 5496136467 Enrollment ID: I20220721003042 |
| Provider Name | Cailee Walden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013421072 PECOS PAC ID: 0648641332 Enrollment ID: I20230117000422 |
| Provider Name | Keisha Taylor-glanville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346733441 PECOS PAC ID: 3274904354 Enrollment ID: I20230127002134 |
| Provider Name | Ruth D Habbouch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588206130 PECOS PAC ID: 0941648828 Enrollment ID: I20240411000597 |
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