Provider Demographics
NPI:1861003808
Name:DMH ENVIRONMENTAL SUPPORT SERVICES
Entity Type:Organization
Organization Name:DMH ENVIRONMENTAL SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:BRACKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-363-8618
Mailing Address - Street 1:11111 BISCAYNE BLVD # 712
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3404
Mailing Address - Country:US
Mailing Address - Phone:917-363-8618
Mailing Address - Fax:212-504-2697
Practice Address - Street 1:1776 BROADWAY STE 1410
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2030
Practice Address - Country:US
Practice Address - Phone:917-363-8618
Practice Address - Fax:212-504-2697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty