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8115 164th St Jamaica NY 11432-1118 | |
| (718) 380-3000 | |
| (718) 969-5426 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8115 164th St, Jamaica, New York |
| Authorized Official Name and Position | Charles Hope (REVENUE MANAGER) |
| Authorized Official Contact | 7183803000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8115 164th St Jamaica NY 11432-1118 Ph: (718) 380-3000 | 8115 164th St Jamaica NY 11432-1118 Ph: (718) 380-3000 |
| NPI Number | 1023297710 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 10/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023297710 | NPI | - | NPPES |
| 00245372 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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