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General NPI Number Information
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NPI Number | 1851936363
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH NYC IPA, LLC
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 8 W 86TH ST
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City | NEW YORK
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State | NY
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Zip | 10024-3629
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Country | US
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Telephone | 929-371-1309
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Fax |
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Provider Business Mailing Address
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Address Line | 8 W 86TH ST
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City | NEW YORK
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State | NY
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Zip | 10024-3629
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JOHN JAVIS
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Credential |
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Telephone | 929-603-6858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation 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 | 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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