Provider Demographics
NPI:1134586662
Name:MENTAL HEALTH AND RECOVERY LLC
Entity type:Organization
Organization Name:MENTAL HEALTH AND RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUNEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-455-3893
Mailing Address - Street 1:25 BROAD ST
Mailing Address - Street 2:APT 12D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2517
Mailing Address - Country:US
Mailing Address - Phone:347-903-1117
Mailing Address - Fax:
Practice Address - Street 1:160 BROADWAY
Practice Address - Street 2:SUITE 601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4201
Practice Address - Country:US
Practice Address - Phone:347-903-1117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1679939425OtherNPI 1