Organization
BENDEL YOUTH EMPOWERMENT PROGRAM
Active
Organization
BENDEL YOUTH EMPOWERMENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FESTUS AGBONLAHOR (CHIEF EXECUTIVE OFFICER)
(914) 434-2078
Entity
Organization
Contact information
Practice address
384 E 149TH ST STE 527, BRONX, NY 10455-3908
(914) 434-2078
Mailing address
2456 BRONX PARK E APT 3, BRONX, NY 10467-7502
(914) 434-2078
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
070833
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861797896
NPPES
NY
Enumeration date
11/30/2017
Last updated
11/30/2017
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