Healthcare Provider Details

I. General information

NPI: 1972220184
Provider Name (Legal Business Name): CHRISBET SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 10/27/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 WATERLOO PL
BRONX NY
10460-4706
US

IV. Provider business mailing address

1830 WATERLOO PL
BRONX NY
10460-4706
US

V. Phone/Fax

Practice location:
  • Phone: 347-304-4051
  • Fax:
Mailing address:
  • Phone: 347-304-4051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: BEATRICE O OKAGBARE
Title or Position: OWNER
Credential:
Phone: 347-304-4051