Organization
ACHIEVE BEYOND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANA DENNIE (CREDENTIALING SPECIALIST- AFFILIATE)
(718) 886-7633
Entity
Organization
Contact information
Practice address
7000 AUSTIN ST, SUITE 200, FOREST HILLS, NY 11375
(718) 886-7633
Mailing address
11041 107TH ST, OZONE PARK, NY 11417-2656
(646) 717-3004
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
998586405
NY
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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