Organization
PHOENIX HOUSES OF LONG ISLAND, INC.
Active
Other names
Apple Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YAREKA CARTER (CFO)
(718) 222-6675
Entity
Organization
Contact information
Practice address
998 CROOKED HILL RD, BUILDING #5, BRENTWOOD, NY 11717-1043
(631) 306-5749
Mailing address
PO BOX 3001, BRENTWOOD, NY 11717-3001
(718) 222-6675
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
5154204R
NY
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01035285
—
NY
05
—
01519066
—
NY
05
—
02994498
—
NY
Enumeration date
11/30/2006
Last updated
01/22/2021
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