Organization
PIBLY RESIDENTIAL PROGRAMS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JENNINGS (EXECUTIVE DIRECTOR)
(718) 863-4100
Entity
Organization
Contact information
Practice address
2415 WESTCHESTER AVENUE, BRONX, NY 10461-3538
(718) 863-4100
(718) 863-5165
Mailing address
2415 WESTCHESTER AVENUE, BRONX, NY 10461-3538
(718) 863-4100
(718) 863-5165
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
6275430
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01304067
—
NY
Enumeration date
07/24/2007
Last updated
09/19/2016
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