Organization
THE EDUCATIONAL ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA MELISSA MARABLE (BILLING COORDINATOR)
(646) 395-4418
Entity
Organization
Contact information
Practice address
25-29 AVENUE D, NEW YORK, NY 10009-6935
(212) 780-5475
(212) 780-5474
Mailing address
197 E BROADWAY, NEW YORK, NY 10002-5507
(646) 395-4280
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
080610221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080610221
OASAS LICENSE
NY
Enumeration date
05/22/2007
Last updated
10/17/2018
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