Healthcare Provider Details

I. General information

NPI: 1609399005
Provider Name (Legal Business Name): DORSETTE MAPP ADULT DAY PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 07/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 DECATUR ST
BROOKLYN NY
11233-1508
US

IV. Provider business mailing address

701 RUTLAND RD.
BROOKLYN NY
11203-1807
US

V. Phone/Fax

Practice location:
  • Phone: 718-756-1108
  • Fax:
Mailing address:
  • Phone: 347-693-0193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DORSETTE MAPP
Title or Position: OWNER
Credential:
Phone: 347-693-0193