Organization
INSTITUTE FOR COMMUNITY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER CAMPANELLI (PRESIDENT)
(212) 385-3030
Entity
Organization
Contact information
Practice address
2384 ATLANTIC AVENUE, BROOKLYN, NY 11322
(212) 385-3030
(212) 385-2380
Mailing address
40 RECTOR ST, NEW YORK, NY 10006-1705
(212) 385-3030
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
074164
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01551404
—
NY
Enumeration date
08/29/2008
Last updated
08/29/2008
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