MEDICARE: WOMENS LEAGUE COMMUNITY RESIDENCE

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	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982810255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMENS LEAGUE COMMUNITY RESIDENCE

Provider Business Mailing Address
First Line	:	1400 CONEY ISLAND AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230
Country	:	US
Telephone Number	:	718-853-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	867 45TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-1610
Country	:	US
Telephone Number	:	718-853-0900
Fax Number	:	171-863-3681

Authorized Official
Title or Position	:	CEO
Name	:	MR. BRIAN SEEWALD
Credential	:
Telephone Number	:	718-853-0900

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/11/2025

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