Healthcare Provider Details

I. General information

NPI: 1497056725
Provider Name (Legal Business Name): HAC FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 RIVER AVE 2ND FLOOR
BRONX NY
10452-9431
US

IV. Provider business mailing address

880 RIVER AVE 2ND FLOOR
BRONX NY
10452-9431
US

V. Phone/Fax

Practice location:
  • Phone: 718-992-1321
  • Fax: 718-992-8539
Mailing address:
  • Phone: 718-992-1321
  • Fax: 718-992-8539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES W NATHANIEL
Title or Position: CEO
Credential:
Phone: 718-992-1321