Organization
BROOKVILLE CENTER FOR CHILDRENS SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLARD T DERR (CHIEF FINANCIAL OFFICER)
(516) 626-1075
Entity
Organization
Contact information
Practice address
30 SEASPRAY DR, LIDO BEACH, NY 11561-5232
(516) 626-1075
(516) 626-3308
Mailing address
189 WHEATLEY RD, GLEN HEAD, NY 11545-2641
(516) 626-1075
(516) 626-3308
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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