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General NPI Number Information
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NPI Number | 1801014634
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Entity Type | Organization
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Legal Business Name | IRI: INNOVATIVE RESOURCES FOR INDEPENDENCE
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 10108 PARK LN S
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City | RICHMOND HILL
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State | NY
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Zip | 11418-1146
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Country | US
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Telephone | 718-805-6796
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Fax | 718-805-4211
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Provider Business Mailing Address
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Address Line | 112-40 FRANCIS LEWIS BLVD. 2ND FLOOR
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429-2235
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Country | US
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Telephone | 718-805-6796
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Fax | 718-776-2724
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Authorized Official
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Title or Position | ASSOCIATE EXECUTIVE DIR. OF ADMIN.
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Name | MR. JAMES MAGALEE
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Credential |
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Telephone | 718-805-6796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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