Organization
MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.
Active
Organization
MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.
Active
Other names
Mental Health Providers of Western Queens, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA E MARTINEZ-CAO (SENIOR OFFICE MANAGER)
(718) 672-1705
Entity
Organization
Contact information
Practice address
74 09 37TH AVE, SUITE 315, JACKSON HEIGHTS, NY 11372-6303
(718) 672-1705
(718) 672-2027
Mailing address
74 09 37TH AVE SUITE 315, JACKSON HEIGHTS, NY 11372-6303
(718) 672-1705
(718) 672-2027
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00848453
—
NY
Enumeration date
01/30/2007
Last updated
08/11/2009
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