Organization
CATHOLIC CHARITIES DAY TREATMENT COMMACK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN KENNEDY (CFO)
(516) 733-7040
Entity
Organization
Contact information
Practice address
155 INDIAN HEAD RD, COMMACK, NY 11725-2212
(631) 543-6200
Mailing address
90 CHERRY LN, HICKSVILLE, NY 11801-6232
(516) 733-7040
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00668864
—
NY
Enumeration date
06/05/2009
Last updated
06/05/2009
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