Provider Demographics
NPI:1720254287
Name:HARLEM DOWLING WEST SIDE CENTER FOR CHILDREN AND FAMILIES SERVICES
Entity Type:Organization
Organization Name:HARLEM DOWLING WEST SIDE CENTER FOR CHILDREN AND FAMILIES SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-749-3656
Mailing Address - Street 1:2090 ADAM CLAYTON POWELL JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4990
Mailing Address - Country:US
Mailing Address - Phone:212-749-3656
Mailing Address - Fax:212-749-1151
Practice Address - Street 1:2090 ADAM CLAYTON POWELL JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4990
Practice Address - Country:US
Practice Address - Phone:212-749-3656
Practice Address - Fax:212-749-1151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01561320Medicaid
NY00343068Medicaid