Provider Demographics
NPI:1851840185
Name:ANCHOR HOUSE, INC.
Entity Type:Organization
Organization Name:ANCHOR HOUSE, INC.
Other - Org Name:WOMEN'S FACILITY
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CASAC
Authorized Official - Phone:718-771-0760
Mailing Address - Street 1:1041 BERGEN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3307
Mailing Address - Country:US
Mailing Address - Phone:718-771-0760
Mailing Address - Fax:718-771-0960
Practice Address - Street 1:976 PARK PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-1803
Practice Address - Country:US
Practice Address - Phone:718-756-8673
Practice Address - Fax:718-756-4527
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANCHOR HOUSE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160810212324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility