Organization
INSTITUTE FOR COMMUNITY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEWEY HOWARD CPA (CHIEF FINANCIAL OFFICER)
(212) 385-3030
Entity
Organization
Contact information
Practice address
161 EMERSON PLACE, BROOKLYN, NY 11205
(718) 636-1463
(718) 636-1710
Mailing address
40 RECTOR STREET, NEW YORK, NY 10006-1705
(212) 385-3030
(212) 374-9225
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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