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General NPI Number Information
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NPI Number | 1437528510
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Entity Type | Organization
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Legal Business Name | CENTRO DE AMIGOS, LLC
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 10/07/2016
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Provider Practice Location Address
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Address Line | 91 BROADWAY
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City | HAVERSTRAW
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State | NY
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Zip | 10927-1144
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Country | US
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Telephone | 845-553-9777
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Fax | 845-553-9776
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Provider Business Mailing Address
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Address Line | 1208 CENTRAL AVE
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City | UNION CITY
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State | NJ
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Zip | 07087-3122
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Country | US
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Telephone | 201-736-6754
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ENID KARPEH
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Credential |
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Telephone | 201-736-6754
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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 |
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License Number State |
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