Organization
EASTSIDE SERVICES (NEW LIFE CENTER), LLC
Active
Other names
ESNLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SANYALE JONES MPH,MS (OWNER/PRESIDENT)
(917) 864-1233
Entity
Organization
Contact information
Practice address
2425 23RD ST, 2ND FLOOR, ASTORIA, NY 11102-2837
(917) 864-1233
Mailing address
2425 23RD ST, 2ND FLOOR, ASTORIA, NY 11102-2837
(917) 864-1233
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
00000000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
SUBCONTRACT CLINICAL SERVICES
NY
Enumeration date
04/23/2013
Last updated
04/23/2013
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