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General NPI Number Information
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NPI Number | 1336650902
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Entity Type | Organization
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Legal Business Name | THE WARTBURG HOME OF THE EVANGELICAL LUTHERAN CHURCH, INC.
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 71 LINCOLN AVE
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-3922
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Country | US
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Telephone | 914-513-5472
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Fax | 914-699-2512
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Provider Business Mailing Address
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Address Line | 1 WARTBURG PL BLDG 6
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City | MOUNT VERNON
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State | NY
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Zip | 10552-3821
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Country | US
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Telephone | 914-513-5106
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Fax | 914-699-2512
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Authorized Official
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Title or Position | DIRECTOR OF BUDGET & REIMBURSEMENT
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Name | MS. EILEEN PANE
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Credential |
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Telephone | 914-513-5106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 5903309N
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License Number State | NY
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