Provider Demographics
NPI:1518091271
Name:BROOKLYN COMMUNITY HOUSING & SERVICES, INC.
Entity Type:Organization
Organization Name:BROOKLYN COMMUNITY HOUSING & SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-625-4545
Mailing Address - Street 1:105 CARLTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-2201
Mailing Address - Country:US
Mailing Address - Phone:718-625-4545
Mailing Address - Fax:718-625-0635
Practice Address - Street 1:105 CARLTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-2201
Practice Address - Country:US
Practice Address - Phone:718-625-4545
Practice Address - Fax:718-625-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7403432320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01304645Medicaid