Organization
OUR LADY OF MERCY MHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATONDRA M BLACK LMSW (THERAPIST)
(718) 304-7022
Entity
Organization
Contact information
Practice address
4401 BX. BOULEVARD, BRONX, NY 10470
(718) 304-7022
Mailing address
1950 ANDREWS AVE APT 7E4, BRONX, NY 10453-2814
(718) 466-0122
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
071466-1
NY
Other
Enumeration date
04/04/2007
Last updated
06/24/2008
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