Provider First Line Business Practice Location Address:
10-24 49 AVENUE
Provider Second Line Business Practice Location Address:
BIRCH FAMILY SERVICES
Provider Business Practice Location Address City Name:
LONG ISLAND CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-786-1104
Provider Business Practice Location Address Fax Number:
718-391-0040
Provider Enumeration Date:
10/08/2009