Organization
FAITH MISSION ALCOHOL CRISIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAURICE LACEY (EXECUTIVE DIRECTOR)
(718) 322-3455
Entity
Organization
Contact information
Practice address
114-40 VAN WYCK EXPRESSWAY, SOUTH OZONE PARK, NY 11420
(718) 322-3455
(718) 848-4152
Mailing address
114-40 VAN WYCK EXPRESSWAY, SOUTH OZONE PARK, NY 11420
(718) 322-3455
(718) 848-4152
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
140710094
NY
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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