Organization
BLUE HAVEN CONSULTATION SERVICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHY FRAZIER (PROGRAM DIRECTOR)
(718) 415-3832
Entity
Organization
Contact information
Practice address
20417 HILLSIDE AVE, SUITE #309, HOLLIS, NY 11423-2213
(718) 415-3832
Mailing address
20417 HILLSIDE AVE, SUITE #309, HOLLIS, NY 11423-2213
(718) 415-3832
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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