Organization Name: | OUTREACH DEVELOPMENT CORPORATION |
NPI Number: | 1083717326 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NEIL SHEEHAN (EXECUITVE VICE PRESIDENT) |
Mailing Address: | 11711 Myrtle Avenue Richmond Hill |
State: | NY US |
Postal Code: | 114181751 |
Phone Number: | 7188479233 |
Fax Number: | 7188491093 |
NPI Enumeration Date: | 09/05/2006 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 081110563 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |