MEDICARE: UNIQUE CARE COMMUNITY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1649123522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUE CARE COMMUNITY SERVICES, INC.

Provider Business Mailing Address
First Line	:	9317 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4806
Country	:	US
Telephone Number	:	347-784-4622
Fax Number	:	347-784-4622

Provider Business Practice Location Address
First Line	:	9317 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4806
Country	:	US
Telephone Number	:	347-784-4622
Fax Number	:	718-504-5304

Authorized Official
Title or Position	:	CEO
Name	:	AEON CLARK
Credential	:
Telephone Number	:	347-502-2956

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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