Organization
CHEVRA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHURBA (MANAGER)
(718) 916-0609
Entity
Organization
Contact information
Practice address
1622 CONEY ISLAND AVE, BROOKLYN, NY 11230-4700
(718) 916-0609
Mailing address
1435 E 18TH ST, BROOKLYN, NY 11230-6705
(718) 916-0609
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0560
—
NY
05
—
0580
—
NY
05
—
0581
—
NY
05
—
0582
—
NY
05
—
0590
—
NY
05
—
0591
—
NY
Enumeration date
05/21/2025
Last updated
07/02/2025
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