Provider Demographics
NPI:1528106549
Name:PSYCHOTHERAPY AND QUALITY ASSURANCE SERVICES
Entity type:Organization
Organization Name:PSYCHOTHERAPY AND QUALITY ASSURANCE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-282-0777
Mailing Address - Street 1:83 NEWPORT ST
Mailing Address - Street 2:2 R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4012 CHURCH AVE
Practice Address - Street 2:# 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2917
Practice Address - Country:US
Practice Address - Phone:718-282-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services