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General NPI Number Information
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NPI Number | 1194400309
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Entity Type | Organization
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Legal Business Name | VILLAGE MENTAL HEALTH INC
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 1137 W 127TH ST
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City | CALUMET PARK
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State | IL
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Zip | 60827-6537
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Country | US
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Telephone | 312-852-4680
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Fax |
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Provider Business Mailing Address
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Address Line | 26 COURT ST STE 409
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City | BROOKLYN
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State | NY
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Zip | 11242-1134
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KRISTIN GILL
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Credential | MD
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Telephone | 718-736-2821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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