1720324650 NPI number — CARE FOR THE HOMELESS

Table of content: (NPI 1720324650)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720324650 NPI number — CARE FOR THE HOMELESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE FOR THE HOMELESS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CARE FOR THE HOMELESS SPRINGFIELD GARDENS FAMILY INN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720324650
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 E 33RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-5337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-366-4459
Provider Business Mailing Address Fax Number:
212-366-1773

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
146-80 GUY BREWER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-426-1642
Provider Business Practice Location Address Fax Number:
212-366-1773
Provider Enumeration Date:
12/21/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FLETCHER BLAKE
Authorized Official First Name:
DEBBIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
212-366-4459

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  70000279R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)