MEDICARE: GEEL COMMUNITY SERVICES, 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	32080000X	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	:	1477700839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEEL COMMUNITY SERVICES, INC.

Provider Business Mailing Address
First Line	:	2516 GRAND AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-4205
Country	:	US
Telephone Number	:	718-367-1900
Fax Number	:	718-365-0252

Provider Business Practice Location Address
First Line	:	2516 GRAND AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-4205
Country	:	US
Telephone Number	:	718-367-1900
Fax Number	:	718-365-0252

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. MARIA LUISA MATIAS
Credential	:	LMSW
Telephone Number	:	718-367-1900

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/27/2008

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