Provider Demographics
NPI:1134930555
Name:OWHEN'S BOX INC.
Entity type:Organization
Organization Name:OWHEN'S BOX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDALUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-223-8893
Mailing Address - Street 1:6 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-3220
Mailing Address - Country:US
Mailing Address - Phone:619-227-6332
Mailing Address - Fax:
Practice Address - Street 1:6 N 5TH ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-3220
Practice Address - Country:US
Practice Address - Phone:631-223-8893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health