Organization
URBAN HEALTH PLAN, INC
Active
Parent organization
ADOLESCENT HEALTH AND WELLNESS CENTER
Other names
ADOLESCENT HEALTH AND WELLNESS CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADOLESCENT HEALTH AND WELLNESS CENTER
Authorized official
DR. SAMUEL DELEON JR. M.D. (VP MEDICAL AFFAIRS/CMO)
(718) 589-2440
Entity
Organization
Contact information
Practice address
960 SOUTHERN BLVD, BRONX, NY 10459-3402
(718) 589-2440
(718) 991-4516
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
(718) 991-4516
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02994952
—
NY
01
—
331015
SITE MEDICARE ID #
NY
Enumeration date
02/28/2011
Last updated
07/24/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us