Healthcare Provider Details

I. General information

NPI: 1124315593
Provider Name (Legal Business Name): UNION SETTLEMENT MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2089 3RD AVE
NEW YORK NY
10029-2184
US

IV. Provider business mailing address

2089 3RD AVE
NEW YORK NY
10029-2184
US

V. Phone/Fax

Practice location:
  • Phone: 212-828-6144
  • Fax:
Mailing address:
  • Phone: 212-828-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CARINE MBIDA
Title or Position: CONTROLLER
Credential:
Phone: 212-828-6033