Organization
MIH VICTORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERCILIA GARCIA (DIRECTOR)
(212) 256-0725
Entity
Organization
Contact information
Practice address
311 AUDUBON AVE FL 2, NEW YORK, NY 10033-4237
(212) 256-0725
(917) 261-4704
Mailing address
311 AUDUBON AVE FL 2, NEW YORK, NY 10033-4237
(212) 256-0725
(917) 261-4704
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
170111976
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170111976
OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
NY
Enumeration date
02/02/2016
Last updated
02/02/2016
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