Healthcare Provider Details

I. General information

NPI: 1821263377
Provider Name (Legal Business Name): UCP OF QUEENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8115 164TH ST
JAMAICA NY
11432-1118
US

IV. Provider business mailing address

8115 164TH ST
JAMAICA NY
11432-1118
US

V. Phone/Fax

Practice location:
  • Phone: 718-380-3000
  • Fax: 718-969-5426
Mailing address:
  • Phone: 718-380-3000
  • Fax: 718-969-5426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES HOPE
Title or Position: REVENUE MANAGER
Credential:
Phone: 718-380-3000