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General NPI Number Information
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NPI Number | 1609293612
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Entity Type | Organization
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Legal Business Name | CITISOCIAL NEW YORK, LLC
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 154 W 127TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-3739
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Country | US
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Telephone | 917-312-0561
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Fax |
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Provider Business Mailing Address
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Address Line | 154 W 127TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-3739
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Country | US
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Telephone | 917-312-0561
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SILVA FRANKLIN UMUKORO
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Credential |
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Telephone | 917-312-0561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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