Healthcare Provider Details

I. General information

NPI: 1528951571
Provider Name (Legal Business Name): URBAN INDIGENOUS COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 39TH ST RM 1206
NEW YORK NY
10018-4064
US

IV. Provider business mailing address

315 W 39TH ST RM 1206
NEW YORK NY
10018-4064
US

V. Phone/Fax

Practice location:
  • Phone: 201-878-4932
  • Fax:
Mailing address:
  • Phone: 201-878-4932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIANNE ALMERO
Title or Position: COMMUNITY WELLNESS SPECIALIST
Credential: LMSW
Phone: 714-574-0344