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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