MEDICARE: SHELTERING ARMS

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831636265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELTERING ARMS

Provider Business Mailing Address
First Line	:	14620 232ND ST
Second Line	:
City	:	SPRINGFIELD GARDENS
State	:	NY
Zip	:	11413-4443
Country	:	US
Telephone Number	:	201-344-1868
Fax Number	:

Provider Business Practice Location Address
First Line	:	10000 BEACH CHANNEL DR
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11694-2818
Country	:	US
Telephone Number	:	718-734-3290
Fax Number	:

Authorized Official
Title or Position	:	SOCIAL WORK INTERN
Name	:	MISS STEPHANIE GBAGUIDI
Credential	:	BSW
Telephone Number	:	201-344-1868

Provider Enumeration Date	:	01/24/2017
Last Update Date	:	01/24/2017

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Directions to “SHELTERING ARMS ” Practice Location

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