Provider Demographics
NPI:1619166741
Name:BRAVERHOOD
Entity Type:Organization
Organization Name:BRAVERHOOD
Other - Org Name:HAND IN HAND FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BENEDEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-336-6073
Mailing Address - Street 1:1527 60TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5023
Mailing Address - Country:US
Mailing Address - Phone:718-336-6073
Mailing Address - Fax:718-336-6071
Practice Address - Street 1:1527 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5023
Practice Address - Country:US
Practice Address - Phone:718-336-6073
Practice Address - Fax:718-336-6071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
02784834251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03132670Medicaid
NY02784834Medicaid
NY06003263Medicaid