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General NPI Number Information
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NPI Number | 1366938839
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Entity Type | Organization
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Legal Business Name | INWOOD THERAPEUTIC SERVICES INC.
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 07/07/2018
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Provider Practice Location Address
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Address Line | 5030 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10034-1609
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Country | US
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Telephone | 917-968-0532
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Fax |
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Provider Business Mailing Address
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Address Line | 48 NORMANDY VLG UNIT 3
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City | NANUET
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State | NY
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Zip | 10954-2859
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Country | US
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Telephone | 917-968-0532
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROGER A CRAWFORD
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Credential |
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Telephone | 917-968-0532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 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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