Organization
JBFCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH OSBORN PHD (CLINICAL DIRECTOR)
(718) 549-6700
Entity
Organization
Contact information
Practice address
2953 BRUNER AVENUE, BRONX, NY 10469
(718) 671-0680
Mailing address
2953 BRUNER AVE, BRONX, NY 10469-3313
(718) 671-0680
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
294665-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
294665-1
—
NY
Enumeration date
11/07/2011
Last updated
11/07/2011
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