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NPI Code Detail

MEDICARE: VIP COMMUNITY SERVCES

MEDICARE: VIP COMMUNITY SERVCES
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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1114468220
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIP COMMUNITY SERVCES
Provider Business Mailing Address
First Line : 764 E 176TH ST
Second Line :
City : BRONX
State : NY
Zip : 10460-4606
Country : US
Telephone Number : 718-542-8770
Fax Number : 718-617-4054
Provider Business Practice Location Address
First Line : 764 E 176TH ST
Second Line :
City : BRONX
State : NY
Zip : 10460-4606
Country : US
Telephone Number : 718-542-8770
Fax Number : 718-617-4054
Authorized Official
Title or Position : CLINICAL COUSNELOR
Name : MR. KENNETH JONES
Credential : CASAC-T
Telephone Number : 718-542-8770
Provider Enumeration Date : 03/09/2017
Last Update Date : 03/09/2017

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Directions to “VIP COMMUNITY SERVCES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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