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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