1811233786 NPI number — CARE FOR THE HOMELESS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811233786 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 ST JOHN'S BREAD AND LIFE PROGRAM
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:
1811233786
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:
795 LEXINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11221-2903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-294-2412
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)





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