Provider Demographics
NPI:1609263698
Name:CENTER FOR BEHAVIORAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CENTER FOR BEHAVIORAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:WIEDER
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:718-312-3919
Mailing Address - Street 1:1931 MOTT AVE
Mailing Address - Street 2:SUITE 317
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4100
Mailing Address - Country:US
Mailing Address - Phone:718-312-3919
Mailing Address - Fax:718-327-2401
Practice Address - Street 1:1 SMITH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5111
Practice Address - Country:US
Practice Address - Phone:718-210-3800
Practice Address - Fax:718-222-2982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health