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General NPI Number Information
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NPI Number | 1023280708
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Entity Type | Organization
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Legal Business Name | SI BEHAVIORAL NETWORK, INC.
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 4434 AMBOY ROAD 2ND FLOOR
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City | STATEN ISLAND
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State | NY
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Zip | 10312
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Country | US
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Telephone | 718-351-5530
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Fax | 718-356-2068
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Provider Business Mailing Address
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Address Line | 4434 AMBOY ROAD 2ND FLOOR
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City | STATEN ISLAND
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State | NY
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Zip | 10312
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Country | US
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Telephone | 718-351-5530
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Fax | 718-356-2068
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Authorized Official
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Title or Position | SENIOR VP
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Name | JENNIFER ARLEN
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Credential |
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Telephone | 718-351-5530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NY
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