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General NPI Number Information
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NPI Number | 1467869602
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Entity Type | Organization
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Legal Business Name | PROVIDENCE CARE INC
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 835 HERKIMER ST
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City | BROOKLYN
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State | NY
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Zip | 11233-3031
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Country | US
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Telephone | 718-221-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 835 HERKIMER ST
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City | BROOKLYN
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State | NY
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Zip | 11233-3031
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BOARD OF DIRECTORS
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Name | LEOPOLD FRIEDMAN
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Credential |
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Telephone | 347-461-2177
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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 |
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License Number State | NY
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