Provider Demographics
NPI:1265092514
Name:HEAD START HOUSING AND REHABILITATION CORPORATION
Entity type:Organization
Organization Name:HEAD START HOUSING AND REHABILITATION CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEW
Authorized Official - Suffix:
Authorized Official - Credentials:DBH (ABD)
Authorized Official - Phone:917-924-1879
Mailing Address - Street 1:3818 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2907
Mailing Address - Country:US
Mailing Address - Phone:646-924-1879
Mailing Address - Fax:
Practice Address - Street 1:3818 CHURCH AVE APT 1B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2907
Practice Address - Country:US
Practice Address - Phone:646-901-8673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility