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General NPI Number Information
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NPI Number | 1962790253
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Entity Type | Organization
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Legal Business Name | PPSC
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 80 5TH AVE RM 903A
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City | NEW YORK
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State | NY
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Zip | 10011-7611
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Country | US
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Telephone | 212-633-9162
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Fax | 212-675-4386
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Provider Business Mailing Address
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Address Line | 80 5TH AVE RM 903A
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City | NEW YORK
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State | NY
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Zip | 10011-7611
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Country | US
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Telephone | 212-633-9162
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Fax | 212-675-4386
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LUCIE GROSVENOR
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Credential | LCSW
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Telephone | 212-633-9162
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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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