Provider Demographics
NPI:1144939125
Name:J&R FLEARY'S CENTER INC
Entity type:Organization
Organization Name:J&R FLEARY'S CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHNIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS-CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:917-312-5953
Mailing Address - Street 1:2046 E 64TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5912
Mailing Address - Country:US
Mailing Address - Phone:917-312-5953
Mailing Address - Fax:
Practice Address - Street 1:2046 E 64TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5912
Practice Address - Country:US
Practice Address - Phone:917-312-5953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty