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General NPI Number Information
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NPI Number | 1972989309
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Entity Type | Organization
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Legal Business Name | CORONA SELF HELP CENTER INC.
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Dates
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Enumeration Date | 08/07/2015
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 171 MARKET ST
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1437
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Country | US
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Telephone | 917-675-4334
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Fax | 917-512-4563
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Provider Business Mailing Address
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Address Line | 171 MARKET ST
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1437
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Country | US
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Telephone | 917-675-4334
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Fax | 917-512-4563
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ARMANDO FRANCO
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Credential |
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Telephone | 917-355-3473
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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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