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General NPI Number Information
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NPI Number | 1386194124
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Entity Type | Organization
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Legal Business Name | PAUL J. COOPER CENTER FOR HUMAN SERVICES, INC.
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 235 JEROME ST
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City | BROOKLYN
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State | NY
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Zip | 11207-3209
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Country | US
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Telephone | 718-827-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 510 GATES AVE
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City | BROOKLYN
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State | NY
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Zip | 11216-1506
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Country | US
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Telephone | 718-498-5555
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Fax | 718-498-6868
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Authorized Official
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Title or Position | BILLING OFFICER
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Name | PETER CAMPBELL
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Credential |
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Telephone | 718-498-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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