Organization
CLUBHOUSE OF SUFFOLK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA FRIES LCAT (DEPUTY DIRECTOR)
(631) 369-4418
Entity
Organization
Contact information
Practice address
1380 ROANOKE AVE, RIVERHEAD, NY 11901-2098
(631) 369-4418
(631) 369-4421
Mailing address
1380 ROANOKE AVE, RIVERHEAD, NY 11901-2098
(631) 369-4418
(631) 369-4421
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
X
NY
Other
Enumeration date
12/08/2009
Last updated
07/21/2022
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