Healthcare Provider Details

I. General information

NPI: 1871642488
Provider Name (Legal Business Name): FORDHAM TREMONT COMMUNITY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 188TH ST 5TH FLOOR
BRONX NY
10458-5302
US

IV. Provider business mailing address

260 E 188TH ST 5TH FLOOR
BRONX NY
10458-5302
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-0260
  • Fax: 718-933-2502
Mailing address:
  • Phone: 718-960-0260
  • Fax: 718-933-2502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: BRENDA VALDES
Title or Position: INTAKE WORKER
Credential:
Phone: 718-960-0260