Provider Demographics
NPI:1588122485
Name:ASCEND BEHAVIOR CENTER CORP.
Entity type:Organization
Organization Name:ASCEND BEHAVIOR CENTER CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERRY ANN
Authorized Official - Middle Name:MONTEHERMOSO
Authorized Official - Last Name:CHISHTI
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:134-755-2549
Mailing Address - Street 1:10659 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1541
Mailing Address - Country:US
Mailing Address - Phone:347-552-4549
Mailing Address - Fax:
Practice Address - Street 1:10659 95TH ST
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-1541
Practice Address - Country:US
Practice Address - Phone:347-552-4549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-10
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty