Organization
NEW SPIRIT II INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY BRINN LMSW (CHIEF OPERATING OFFICER)
(718) 712-1100
Entity
Organization
Contact information
Practice address
16204 SOUTH RD, JAMAICA, NY 11433-1608
(718) 291-4844
(718) 291-4511
Mailing address
11630 SUTPHIN BLVD, JAMAICA, NY 11434-1527
(718) 712-1100
(718) 322-1881
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
081110890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01778289
—
NY
01
—
G100050030
MEDICARE PTAN
NY
Enumeration date
11/30/2006
Last updated
12/13/2016
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