Organization
Q.V.C.M.H. J-CAP
Active
Parent organization
QUEENS VILLAGE COMMITTEE FOR MENTAL HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUEENS VILLAGE COMMITTEE FOR MENTAL HEALTH
Authorized official
MS. DIANE GONZALEZ MSW (CHEIF EXCUTIVE OFFICER)
(718) 712-1100
Entity
Organization
Contact information
Practice address
11630 SUTPHIN BLVD, JAMAICA, NY 11434-1527
(718) 322-2500
(718) 322-1881
Mailing address
11630 SUTPHIN BLVD, JAMAICA, NY 11434-1527
(718) 322-2500
(718) 322-1881
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
8492
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8492
LICENSE
NY
Enumeration date
12/17/2015
Last updated
12/17/2015
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