Organization
EATING DISORDER TREATMENT OF NEW YORK, LLC
Active
Other names
Clementine North Shore
Organization subpart
No
Provider details
NPI number
Authorized official
JASON SCHULZ (CHIEF FINANCIAL OFFICER)
(720) 440-4277
Entity
Organization
Contact information
Practice address
254 BREAD AND CHEESE HOLLOW RD, NORTHPORT, NY 11768-2606
(631) 540-0980
(631) 967-1667
Mailing address
6100 SW 76TH ST, SOUTH MIAMI, FL 33143-5002
(305) 663-1876
(786) 359-4485
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
06/05/2025
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