Healthcare Provider Details

I. General information

NPI: 1972223642
Provider Name (Legal Business Name): COMMUNITY SERVICES AND HOUSING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2482 BEAUMONT AVENUE
BRONX NY
10458
US

IV. Provider business mailing address

1449 WEST AVE
BRONX NY
10462-9200
US

V. Phone/Fax

Practice location:
  • Phone: 718-915-6443
  • Fax: 929-290-0328
Mailing address:
  • Phone: 718-915-6443
  • Fax: 929-290-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: ETHEL MORAN
Title or Position: CEO
Credential:
Phone: 718-915-6443