SOLE PROPRIETOR NPI 1891187852

NPI Details

SOLE PROPRIETOR is a community behavioral health in Williston Park, NY. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SOLE PROPRIETOR NPI is 1891187852. The provider is registered as an organization entity type.

The provider's business location address is:

610 WILLIS AVE APT 1F
WILLISTON PARK, NY
ZIP 11596-221
Phone: (516) 770-2383

The provider's authorized official is Brendan Michael Canavan .
The authorized official title is Abss and has the following contact phone number (516) 770-2383.

The enumeration date for this NPI number is 2/28/2015 and was last updated on 2/28/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: