Provider Demographics
NPI:1477163640
Name:BYL- TAEJAH LLC
Entity Type:Organization
Organization Name:BYL- TAEJAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS-RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, HS-BCP, CASAC-M
Authorized Official - Phone:718-696-8124
Mailing Address - Street 1:1953 NEREID AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1247
Mailing Address - Country:US
Mailing Address - Phone:718-696-8124
Mailing Address - Fax:
Practice Address - Street 1:1953 NEREID AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-1247
Practice Address - Country:US
Practice Address - Phone:718-696-8124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness