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General NPI Number Information
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NPI Number | 1134866098
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Entity Type | Organization
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Legal Business Name | SPRING HILL WELLNESS NEW YORK, LLC
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 4105 AVENUE V
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City | BROOKLYN
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State | NY
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Zip | 11234-5157
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Country | US
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Telephone | 518-424-6845
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Fax |
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Provider Business Mailing Address
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Address Line | 4105 AVENUE V
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City | BROOKLYN
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State | NY
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Zip | 11234-5157
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Country | US
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Telephone | 518-424-6845
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MS. SHARI NOONAN
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Credential |
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Telephone | 518-424-6845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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