Organization
SILVER LAKE SUPPORT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVRAHAM SCHICK (EXECUTIVE DIRECTOR)
(718) 720-9600
Entity
Organization
Contact information
Practice address
201 FOREST AVE, STATEN ISLAND, NY 10301-2763
(718) 815-3155
(718) 815-3151
Mailing address
201 FOREST AVE, STATEN ISLAND, NY 10301-2763
(718) 815-3155
(715) 815-3151
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
061110987
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02097574
—
NY
Enumeration date
04/12/2007
Last updated
06/17/2010
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