Organization
SAFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IKE DWECK CPGC, CASAC (EXECUTIVE DIRECTOR)
(866) 569-7233
Entity
Organization
Contact information
Practice address
255 AVENUE W, BROOKLYN, NY 11223-5202
(866) 569-7233
Mailing address
255 AVENUE W, BROOKLYN, NY 11223-5202
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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