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General NPI Number Information
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NPI Number | 1962544916
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Entity Type | Organization
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Legal Business Name | EAST HARLEM COUNCIL FOR COMMUNITY IMPROVEMENT
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 348 E 105 ST
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone | 212-410-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 413 E 120TH ST FISCAL AT CLAY AVE
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City | NEW YORK
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State | NY
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Zip | 10035-3602
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Country | US
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Telephone | 212-410-7707
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. TOMAS DEL RIO
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Credential |
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Telephone | 347-649-3083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 8222443
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 8222441
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 8222442
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License Number State | NY
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