Healthcare Provider Details

I. General information

NPI: 1750934436
Provider Name (Legal Business Name): HOUSING WORKS HEALTH SERVICES III, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 PITKIN AVE OASAS DEPARTMENT
BROOKLYN NY
11208-2629
US

IV. Provider business mailing address

57 WILLOUGHBY ST
BROOKLYN NY
11201-5257
US

V. Phone/Fax

Practice location:
  • Phone: 718-827-8700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEBORA CARRERO
Title or Position: DIRECTOR OF CREDENTIALLING
Credential:
Phone: 718-408-6522