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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANTHONY HENDRICKSON (CEO)
(732) 430-9020
Entity
Organization

Contact information

Practice address
2916 8TH AVE STE 2, NEW YORK, NY 10039-1619
(732) 430-9020
Mailing address
8 W 126TH ST, NEW YORK, NY 10027-3811
(732) 430-9020

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
03/29/2025
Last updated
03/29/2025
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