Provider Demographics
NPI:1508223934
Name:SOUTH RICHMOND HILL RECOVERY LLC
Entity Type:Organization
Organization Name:SOUTH RICHMOND HILL RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:347-743-1598
Mailing Address - Street 1:8768 114TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2438
Mailing Address - Country:US
Mailing Address - Phone:347-743-1598
Mailing Address - Fax:
Practice Address - Street 1:8808 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-1329
Practice Address - Country:US
Practice Address - Phone:347-743-1598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health