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Organization

COMMUNITY PARTNERSHIP RESOURCE AND REFERRALS

Active
Other names
Community Partnership Referrals and Resources
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TRACIE THEOTOKAS LCSW (SOCIAL WORKER)
71822488010
Entity
Organization

Contact information

Practice address
25410 NORTHERN BLVD, SUITE 204, LITTLE NECK, NY 11362-1415
(718) 224-2010
(718) 225-3366
Mailing address
25410 NORTHERN BLVD, SUITE 204, LITTLE NECK, NY 11362-1415
(718) 224-2010
(718) 225-3366

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
074639
NY

Other

Enumeration date
04/22/2008
Last updated
04/22/2008
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