# MARTIN DE PORRES GROUP HOMES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629163563
- **Authorized official:** PHILIP ROFRANO LCSW (PRESIDENT EXECUTIVE DIRECTOR)
- **Authorized official phone:** (718) 527-0606

## Contact information

- **Practice address:** 136 25 218TH STREET, SPRINGFIELD GARDENS, NY 11413-2226
- **Practice address phone:** (718) 527-0606
- **Practice address fax:** (718) 723-1528
- **Mailing address:** 136 25 218TH STREET, SPRINGFIELD GARDENS, NY 11413-2226
- **Mailing address phone:** (718) 527-0606
- **Mailing address fax:** (718) 723-1528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 00328116 | NY | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00328116 | — | NY |