MEDICARE: OHEL CHILDREN'S HOME &FAMILY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility		NY

General Provider Information

NPI Number	:	1093839151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHEL CHILDREN'S HOME &FAMILY SERVICES

Provider Business Mailing Address
First Line	:	156 BEACH 9TH ST FL 2
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-5636
Country	:	US
Telephone Number	:	718-686-3202
Fax Number	:	718-686-4202

Provider Business Practice Location Address
First Line	:	5211 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NM
Zip	:	11219
Country	:	US
Telephone Number	:	718-972-1377
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID MANDEL
Credential	:
Telephone Number	:	718-686-3202

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	01/08/2018

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