Healthcare Provider Details

I. General information

NPI: 1720998727
Provider Name (Legal Business Name): ALLERTON COMMUNITY AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2529 MATTHEWS AVE APT 5E
BRONX NY
10467-9150
US

IV. Provider business mailing address

2529 MATTHEWS AVE APT 5E
BRONX NY
10467-9150
US

V. Phone/Fax

Practice location:
  • Phone: 651-800-5760
  • Fax:
Mailing address:
  • Phone: 651-800-5760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE A BRYANT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 651-800-5760