Basic Information
| Provider Information | |||||||||
| NPI: | 1588066716 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARE COUNSELING CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 214 W 116TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100262494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6464324600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 214 W 116TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100262494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6464324600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2014 | ||||||||
| LastUpdateDate: | 09/18/2014 | ||||||||
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| AuthorizedOfficialLastName: | KHWAJA | ||||||||
| AuthorizedOfficialFirstName: | FARRUKH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5164587898 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.