Provider Demographics
NPI:1104236603
Name:SAFE HORIZON COUNSELING CENTER
Entity type:Organization
Organization Name:SAFE HORIZON COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-328-8110
Mailing Address - Street 1:1143 DEAN ST
Mailing Address - Street 2:APT #2F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3088
Mailing Address - Country:US
Mailing Address - Phone:612-716-6398
Mailing Address - Fax:
Practice Address - Street 1:50 COURT ST STE 901
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4879
Practice Address - Country:US
Practice Address - Phone:347-328-8110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091151-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health