Provider Demographics
NPI:1659681138
Name:EIHAB HUMAN SERVICES, INC.
Entity Type:Organization
Organization Name:EIHAB HUMAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FATMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-276-6101
Mailing Address - Street 1:16818 S CONDUIT AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-4899
Mailing Address - Country:US
Mailing Address - Phone:718-276-6101
Mailing Address - Fax:718-276-6063
Practice Address - Street 1:1200 STATE ROUTE 92 SOUTH
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:NY
Practice Address - Zip Code:18657
Practice Address - Country:US
Practice Address - Phone:570-388-6155
Practice Address - Fax:570-388-6979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA323P00000X323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility