Provider Demographics
NPI:1376944660
Name:GODELS BEHAVIORAL HEALTH & WELLNESS CENTER,INC.
Entity Type:Organization
Organization Name:GODELS BEHAVIORAL HEALTH & WELLNESS CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEL
Authorized Official - Middle Name:KATHIE
Authorized Official - Last Name:TOBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-419-0724
Mailing Address - Street 1:1413 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5709
Mailing Address - Country:US
Mailing Address - Phone:347-419-0724
Mailing Address - Fax:
Practice Address - Street 1:1413 E 69TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5709
Practice Address - Country:US
Practice Address - Phone:347-419-0724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-06
Last Update Date:2014-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY451516251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health