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Organization

MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHERYL LAZO MONTANEZ LMSW (PROGRAM DIRECTOR)
(718) 898-5085
Entity
Organization

Contact information

Practice address
6207 WOODSIDE AVE, 4TH FLOOR, WOODSIDE, NY 11377-3576
(718) 898-5085
(718) 898-8852
Mailing address
6207 WOODSIDE AVE, 4TH FLOOR, WOODSIDE, NY 11377-3576
(718) 898-5085
(718) 898-8852

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
096826
NY

Other

Enumeration date
01/26/2016
Last updated
01/26/2016
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