# EATING DISORDER TREATMENT OF NEW YORK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clementine Briarcliff Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023560380
- **Authorized official:** MR. JASON SHULTZ (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (720) 440-4277

## Contact information

- **Practice address:** 233 PINE RD, BRIARCLIFF MANOR, NY 10510-2236
- **Practice address phone:** (310) 589-8999
- **Practice address fax:** (310) 589-9201
- **Mailing address:** 6100 SW 76TH STREET, SOUTH MIAMI, FL 33143
- **Mailing address phone:** (305) 663-1876
- **Mailing address fax:** (914) 479-5490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/02/2016
- **Last updated:** 06/11/2025