Provider Demographics
NPI:1114638178
Name:CHANNEL BEHAVIORAL CARE LLC
Entity Type:Organization
Organization Name:CHANNEL BEHAVIORAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-238-4930
Mailing Address - Street 1:7202 FORT HAMILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1906
Mailing Address - Country:US
Mailing Address - Phone:646-238-4930
Mailing Address - Fax:
Practice Address - Street 1:7202 FORT HAMILTON PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-1906
Practice Address - Country:US
Practice Address - Phone:646-238-4930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty