Organization
ICL-EAST NEW YORK PREVENTION-BASED SATELLITE
Active
Parent organization
INSTITUTE FOR COMMUNITY LIVING, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
INSTITUTE FOR COMMUNITY LIVING, INC.
Authorized official
MR. DEWEY HOWARD (C F O)
(212) 385-3030
Entity
Organization
Contact information
Practice address
40 RECTOR ST FL 11, NEW YORK, NY 10006-1705
(212) 385-3030
Mailing address
350 LINWOOD ST, BROOKLYN, NY 11208-2116
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7720101B
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7720101B
—
NY
Enumeration date
09/03/2008
Last updated
09/03/2008
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