| Organization Name: | SOUTHEAST NASSAU GUIDANCE CENTER INC. |
| NPI Number: | 1083718779 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIE OLIVA (CLINICAL ADMINISTRATOR) |
| Mailing Address: | 2146 Jackson Ave Seaford |
| State: | NY US |
| Postal Code: | 117832606 |
| Phone Number: | 5162213030 |
| Fax Number: | 5162211013 |
| NPI Enumeration Date: | 09/12/2006 |
| NPI Last Update Date: | 10/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 6801100A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |