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General NPI Number Information
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NPI Number | 1104711084
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Entity Type | Organization
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Legal Business Name | FOUR DEANS COMMUNITY OUTREACH FOUNDATION INC.
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 15 W 118TH ST STE UG4
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City | NEW YORK
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State | NY
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Zip | 10026-1984
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Country | US
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Telephone | 929-735-6915
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Fax |
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Provider Business Mailing Address
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Address Line | 15 W 118TH ST STE UG4
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City | NEW YORK
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State | NY
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Zip | 10026-1984
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Country | US
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Telephone | 929-735-6915
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ODETTA DEAN
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Credential |
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Telephone | 917-293-9601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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