Organization
YMCA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH E MC FALL LMHC (COUNSELOR)
(718) 981-4382
Entity
Organization
Contact information
Practice address
285 VANDERBILT AVE, STATEN ISLAND, NY 10304-2525
(718) 981-4382
Mailing address
285 VANDERBILT AVE, STATEN ISLAND, NY 10304-2525
(718) 981-4382
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
005200-1
NY
Other
Enumeration date
02/11/2013
Last updated
02/27/2013
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