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General NPI Number Information
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NPI Number | 1154886372
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Entity Type | Organization
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Legal Business Name | NINE LIVES SANCTUARY
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 1136 NEILL AVE
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City | BRONX
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State | NY
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Zip | 10461-1328
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Country | US
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Telephone | 347-739-8770
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1069
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City | BRONX
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State | NY
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Zip | 10462-0575
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Country | US
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Telephone | 347-739-8770
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DONALD EUGENE COFIELD
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Credential | LMSW
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Telephone | 347-739-8770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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