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General NPI Number Information
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NPI Number | 1730395468
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Entity Type | Organization
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Legal Business Name | CHARLES A. WALBURG MULTI-SERVICE ORGANIZATION, INC.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 163 W 125TH ST ROOM 1320
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City | NEW YORK
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State | NY
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Zip | 10027-4436
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Country | US
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Telephone | 212-222-2552
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Fax |
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Provider Business Mailing Address
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Address Line | 163 W 125TH ST ROOM 1320
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City | NEW YORK
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State | NY
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Zip | 10027-4436
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Country | US
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Telephone | 212-222-2552
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CARLA D. BROWN
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Credential | MPA
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Telephone | 212-222-2552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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