Provider Demographics
NPI:1528283959
Name:COMMUNITY HEALTH ACTION OF STATEN ISLAND, INC.
Entity type:Organization
Organization Name:COMMUNITY HEALTH ACTION OF STATEN ISLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEVLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-808-1416
Mailing Address - Street 1:56 BAY ST FL 6
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2563
Mailing Address - Country:US
Mailing Address - Phone:718-808-1416
Mailing Address - Fax:718-808-1393
Practice Address - Street 1:56 BAY ST FL 6
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2563
Practice Address - Country:US
Practice Address - Phone:718-808-1416
Practice Address - Fax:718-808-1393
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHTPOINT HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-13
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management