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Organization

ICL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROL THOMPSON (CASE MANAGER)
(347) 249-6918
Entity
Organization

Contact information

Practice address
25 CHAPEL ST FL 9, BROOKLYN, NY 11201-1954
(718) 875-7510
Mailing address
3547 NOSTRAND AVE APT 2E, BROOKLYN, NY 11229-5231
(347) 249-6918

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
10/01/2016
Last updated
10/01/2016
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