Organization
FAMILY SERVIVE LEAGUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MCGOWAN (RN)
(631) 284-2565
Entity
Organization
Contact information
Practice address
75 E MAIN ST, RIVERHEAD, NY 11901-2422
(631) 284-2565
Mailing address
75 E MAIN ST, RIVERHEAD, NY 11901-2422
(631) 284-2565
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
445998-1
NY
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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