Organization
FAMILY SERVICE LEAGUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE BRUNNER (LMSW)
(631) 427-3700
Entity
Organization
Contact information
Practice address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 427-3700
(631) 427-0232
Mailing address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 427-3700
(631) 427-0232
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
072457-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072457-1
—
NY
Enumeration date
10/12/2009
Last updated
10/12/2009
Update your record
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