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Organization
ICL GARDEN HOUSE (AVE D) ICF
Active
Organization
ICL GARDEN HOUSE (AVE D) ICF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNETTE BACCHUS (ASST CONTROLLER)
(212) 385-3030
Entity
Organization
Contact information
Practice address
4715 AVENUE D, ICL GARDEN HOUSE (AVE D) ICF, BROOKLYN, NY 11203
(718) 451-2817
Mailing address
4715 AVENUE D, BROOKLYN, NY 11203-5817
(718) 451-2817
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/14/2009
Last updated
03/04/2019
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