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Organization

EVELYN DOUGLIN CENTER SPIN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIELLA VOLCY (AED)
(718) 965-1998
Entity
Organization

Contact information

Practice address
470 CHESTER ST, BROOKLYN, NY 11212-5505
(718) 965-1998
Mailing address
241 37TH ST, BROOKLYN, NY 11232-2417
(718) 965-1998

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
90580471
NY
05
90580472
NY
Enumeration date
01/25/2017
Last updated
01/25/2017
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