Provider Demographics
NPI:1831258862
Name:BROOKLYN BUREAU OF COMMUNITY SERVICE
Entity type:Organization
Organization Name:BROOKLYN BUREAU OF COMMUNITY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR ADULT REHABILITATION SERVI
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CAS
Authorized Official - Phone:718-310-5630
Mailing Address - Street 1:540 ATLANTIC AVENUE
Mailing Address - Street 2:2ND FLOOR RESIDENTIAL HABILITATION SERVICES
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-1024
Mailing Address - Country:US
Mailing Address - Phone:718-222-8632
Mailing Address - Fax:718-596-4589
Practice Address - Street 1:540 ATLANTIC AVENUE
Practice Address - Street 2:2ND FLOOR RESIDENTIAL HABILITATION SERVICES
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1024
Practice Address - Country:US
Practice Address - Phone:718-222-8632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01499476Medicaid