Provider Demographics
NPI:1174783559
Name:FOUNDATION FOR RELIGION AND MENTAL HEALTH
Entity type:Organization
Organization Name:FOUNDATION FOR RELIGION AND MENTAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-461-6393
Mailing Address - Street 1:4343 BOWNE ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3039
Mailing Address - Country:US
Mailing Address - Phone:718-461-6393
Mailing Address - Fax:718-463-8937
Practice Address - Street 1:4343 BOWNE ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3039
Practice Address - Country:US
Practice Address - Phone:718-461-6393
Practice Address - Fax:718-463-8937
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOUNDATION FOR RELIGION AND MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-10
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026Medicare PIN
NYS56754Medicare UPIN