Healthcare Provider Details
I. General information
NPI: 1134593510
Provider Name (Legal Business Name): REVCORE RECOVERY CENTER OF MANHATTAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/23/2015
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
138 E 26TH ST
NEW YORK NY
10010-1843
US
IV. Provider business mailing address
138 E 26TH ST
NEW YORK NY
10010-1843
US
V. Phone/Fax
- Phone: 212-966-9537
- Fax:
- Phone: 212-966-9537
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | 161011950 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 161011950 |
| License Number State | NY |
VIII. Authorized Official
Name:
AVRAHAM
SCHICK
Title or Position: PRESIDENT
Credential:
Phone: 917-743-6302