Organization
WEDIKO CHILDREN'S SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN RENSHAW LCSW (CO-DIRECTOR)
(646) 481-0184
Entity
Organization
Contact information
Practice address
8 HILLSIDE AVE, MONTCLAIR, NJ 07042-2129
(646) 481-0185
Mailing address
421 W 145TH ST, NEW YORK, NY 10031-5203
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
078168
NY
251S00000X
Community/Behavioral Health Agency
Primary
079144-1
NY
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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