Provider First Line Business Practice Location Address:
5601 16TH AVE
Provider Second Line Business Practice Location Address:
IHB DAY TREATMENT CENTER @ PS 180
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11204-1809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-686-1526
Provider Business Practice Location Address Fax Number:
718-854-1483
Provider Enumeration Date:
05/29/2008