MEDICARE: WILLIAM F RYAN COMMUNITY HEALTH CENTER INC

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	320800000X	Mental Illness Community Based Residential Treatment Facility	7002243R	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366716680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM F RYAN COMMUNITY HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	483 W END AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4340
Country	:	US
Telephone Number	:	212-749-1820
Fax Number	:	212-932-8323

Provider Business Practice Location Address
First Line	:	483 W END AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4340
Country	:	US
Telephone Number	:	212-749-1820
Fax Number	:	212-932-8323

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	BRIAN MCINDOE
Credential	:
Telephone Number	:	212-316-7906

Provider Enumeration Date	:	03/05/2012
Last Update Date	:	11/19/2015

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