Provider Demographics
NPI:1518599570
Name:STEWARD RECOVERY SERVICES
Entity Type:Organization
Organization Name:STEWARD RECOVERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF BILLING AND CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KESHALU
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-585-9235
Mailing Address - Street 1:20 E 1ST ST STE 304
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-3311
Mailing Address - Country:US
Mailing Address - Phone:914-369-1543
Mailing Address - Fax:
Practice Address - Street 1:1982 BELMONT AVE # 1F
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4907
Practice Address - Country:US
Practice Address - Phone:347-758-7818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health