Organization
COMMUNITY COUNSELING & MEDIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN ANTONIO LEIGH CASAC (COUNSELOR/CONSULTANT)
(718) 230-5100
Entity
Organization
Contact information
Practice address
367 E 7TH ST, BROOKLYN, NY 11218-4105
(718) 717-9211
Mailing address
367 E 7TH ST, BROOKLYN, NY 11218-4105
(718) 717-9211
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
16697
NY
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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