MEDICARE: BROOKLYN COMMUNITY HOUSING & SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility	7403432	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518091271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKLYN COMMUNITY HOUSING & SERVICES, INC.

Provider Business Mailing Address
First Line	:	105 CARLTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-2201
Country	:	US
Telephone Number	:	718-625-4545
Fax Number	:	718-625-0635

Provider Business Practice Location Address
First Line	:	105 CARLTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-2201
Country	:	US
Telephone Number	:	718-625-4545
Fax Number	:	718-625-0635

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JEFF NEMETSKY
Credential	:
Telephone Number	:	718-625-4545

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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