Organization
BREAD OF LIFE COMMUNITY SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLTON LAMONT JEAN LCSW (PRESIDENT, CEO)
(347) 892-5022
Entity
Organization
Contact information
Practice address
14 W 170TH ST, BRONX, NY 10452-3227
(347) 892-5022
Mailing address
1055 SHERMAN AVE APT 4B, BRONX, NY 10456-5720
(347) 892-5022
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
082977
NY
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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