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General NPI Number Information
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NPI Number | 1508223934
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Entity Type | Organization
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Legal Business Name | SOUTH RICHMOND HILL RECOVERY LLC
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 8808 LIBERTY AVE
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City | OZONE PARK
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State | NY
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Zip | 11417-1329
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Country | US
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Telephone | 347-743-1598
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Fax |
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Provider Business Mailing Address
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Address Line | 8768 114TH ST
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City | RICHMOND HILL
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State | NY
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Zip | 11418-2438
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Country | US
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Telephone | 347-743-1598
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | JOHN SAITH
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Credential | LCSWR
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Telephone | 347-743-1598
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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 | NY
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