Provider Demographics
NPI:1003063876
Name:GUIDANCE CENTER OF BROOKLYN HEIGHTS
Entity Type:Organization
Organization Name:GUIDANCE CENTER OF BROOKLYN HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C I O
Authorized Official - Prefix:MR
Authorized Official - First Name:DEWEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-385-3030
Mailing Address - Street 1:25 CHAPEL ST FL 9
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1952
Mailing Address - Country:US
Mailing Address - Phone:718-875-7510
Mailing Address - Fax:718-858-8410
Practice Address - Street 1:25 CHAPEL ST FL 9
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1952
Practice Address - Country:US
Practice Address - Phone:718-875-7510
Practice Address - Fax:718-858-8410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUIDANCE CENTER OF BROOKLYN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00245065251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00245065Medicaid