MEDICARE: EPRINE COMMUNITY 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1457885378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPRINE COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	1650 EASTERN PKWY STE 400-403
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11233-4804
Country	:	US
Telephone Number	:	718-255-5946
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 EASTERN PKWY STE 400-403
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11233-4804
Country	:	US
Telephone Number	:	718-255-5946
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LUIS MOTA
Credential	:
Telephone Number	:	718-255-5946

Provider Enumeration Date	:	04/18/2017
Last Update Date	:	03/19/2021

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