Provider Demographics
NPI:1164723714
Name:CHILDREN OF PROMISE, NYC
Entity Type:Organization
Organization Name:CHILDREN OF PROMISE, NYC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:CONTENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-483-9290
Mailing Address - Street 1:54 MACDONOUGH ST.
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2304
Mailing Address - Country:US
Mailing Address - Phone:718-483-9290
Mailing Address - Fax:718-414-2715
Practice Address - Street 1:54 MACDONOUGH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2304
Practice Address - Country:US
Practice Address - Phone:718-482-9290
Practice Address - Fax:718-483-9287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-14
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X, 347B00000X
251S00000X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03505424Medicaid