Provider Demographics
NPI:1497139414
Name:BROOKLYN BUREAU OF COMMUNITY SERVICES
Entity Type:Organization
Organization Name:BROOKLYN BUREAU OF COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALISTAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-596-8960
Mailing Address - Street 1:25 CHAPEL ST STE 1204
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1955
Mailing Address - Country:US
Mailing Address - Phone:718-596-8960
Mailing Address - Fax:718-596-8964
Practice Address - Street 1:25 CHAPEL ST STE 1204
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1955
Practice Address - Country:US
Practice Address - Phone:718-596-8960
Practice Address - Fax:718-596-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization