Organization
SILVER LAKE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AVRAHAM SCHICK CASAC (EXECUTIVE DIRECTOR)
(718) 815-3155
Entity
Organization
Contact information
Practice address
201 FOREST AVE, STATEN ISLAND, NY 10301-2763
(718) 815-3155
Mailing address
201 FOREST AVE, STATEN ISLAND, NY 10301-2763
(718) 815-3155
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
576942811
NY
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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