Provider Demographics
NPI:1225405640
Name:GREENWICH HOUSE CHEMICAL DEPENDENCY PROGRAM
Entity Type:Organization
Organization Name:GREENWICH HOUSE CHEMICAL DEPENDENCY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTAKE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-691-2900
Mailing Address - Street 1:122 W 27TH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6291
Mailing Address - Country:US
Mailing Address - Phone:212-691-2900
Mailing Address - Fax:
Practice Address - Street 1:122 W 27TH ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6291
Practice Address - Country:US
Practice Address - Phone:212-691-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health