Organization
SAFE SPACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BLADY (DIRECTOR)
(718) 206-3440
Entity
Organization
Contact information
Practice address
9209 222 STREET, QUEENS VILLAGE, NY 11428
(917) 528-3380
Mailing address
9209 222ND ST, QUEENS VILLAGE, NY 11428-1473
(917) 528-3380
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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