Organization
VIP COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GRISET CASAC (CL.SUPERVISOR)
(718) 542-8770
Entity
Organization
Contact information
Practice address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 542-8770
(718) 617-4054
Mailing address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 542-8770
(718) 617-4054
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
21275
NY
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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