Organization Active NPI

Association to Benefit Children-Fast Break Mobile Mental Health Clinic

  • Community/Behavioral Health Agency
  • New York, NY
National Provider Identifier
1053613489
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
075566 Issued in NY
Legal business name
ASSOCIATION TO BENEFIT CHILDREN-FAST BREAK MOBILE MENTAL HEALTH CLINIC
Practice address
1841 Park Ave
New York, NY 10035-1316
Phone
(646) 459-6142
NPI assigned
Nov 17, 2010
Organization subpart
Yes
Parent organization
ASSOCIATION TO BENEFIT CHILDRENAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Adam Leczycki
Title
Program Director
Phone
(646) 459-6166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 075566 NY Primary

Addresses

Primary practice location

1841 Park Ave
New York, NY 10035-1316

Mailing address

1841 Park Ave
New York, NY 10035-1316
Phone (646) 459-6142

National Provider Directory

National Provider Directory
Part of
Assoc to Benefit Children

Locations

1841 Park Ave
New York, NY 10035
Phone (212) 845-3821

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1053613489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351316",
            "telephone_number": "646-459-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351316",
            "telephone_number": "646-459-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATION TO BENEFIT CHILDREN-FAST BREAK MOBILE MENTAL HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASSOCIATION TO BENEFIT CHILDREN",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "LECZYCKI",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "646-459-6166",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "075566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.