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General NPI Number Information
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NPI Number | 1538371216
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Entity Type | Organization
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Legal Business Name | LDS FAMILY SERVICES
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 217 E 87TH ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10128-3204
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Country | US
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Telephone | 212-876-7427
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 656 217 EAST 87TH ST, 3RD FLOOR
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City | NEW YORK
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State | NY
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Zip | 10028-0006
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Country | US
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Telephone | 212-876-7427
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Fax |
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MR. GEORGE KEM NIXON
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Credential |
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Telephone | 845-462-1288
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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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