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General NPI Number Information
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NPI Number | 1255345245
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Entity Type | Organization
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Legal Business Name | JGB MENTAL HEALTH & MENTAL RETARDATION SERVICES INC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 250 WEST 64 STREET 4TH FL
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City | NEW YORK
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State | NY
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Zip | 10023-6601
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Country | US
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Telephone | 212-769-7800
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Fax | 212-769-7869
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Provider Business Mailing Address
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Address Line | 250 W 64 ST
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City | NEW YORK
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State | NY
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Zip | 10023-6301
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Country | US
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Telephone | 212-769-7800
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Fax | 212-769-7869
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | NICOLE HART
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Credential | JD
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Telephone | 212-769-6212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6711130
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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