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General NPI Number Information
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NPI Number | 1164536660
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Entity Type | Organization
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Legal Business Name | BROOKLYN UNITED METHODIST CHURCH HOME
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 1485 DUMONT AVE
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City | BROOKLYN
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State | NY
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Zip | 11208-4705
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Country | US
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Telephone | 718-827-4500
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Fax | 718-827-7719
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Provider Business Mailing Address
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Address Line | 1485 DUMONT AVE
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City | BROOKLYN
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State | NY
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Zip | 11208-4705
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Country | US
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Telephone | 718-827-4500
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Fax | 718-827-7719
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Authorized Official
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Title or Position | CFO
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Name | MS. SANDRA D PITTERSON
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Credential |
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Telephone | 718-827-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 7001308N
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License Number State | NY
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