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General NPI Number Information
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NPI Number | 1942029939
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Entity Type | Organization
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Legal Business Name | CATHOLIC MANAGED LONG TERM CARE INC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1918 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10029-7492
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Country | US
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Telephone | 646-633-4702
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Fax |
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Provider Business Mailing Address
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Address Line | 205 LEXINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6022
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Country | US
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Telephone | 646-633-4702
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Fax | 646-633-4701
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Authorized Official
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Title or Position | CFO/CAO
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Name | ANNMARIE COVONE
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Credential |
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Telephone | 646-633-4702
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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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