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Organization

PROMESA ADULT DAY HEALTH CARE

Active
Parent organization
PROMESA RESIDENTIAL HEALTHCARE FACILITY, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROMESA RESIDENTIAL HEALTHCARE FACILITY, INC
Authorized official
MR. MILTON DERIENZO (CHIEF FINANCIAL OFFICIER)
(347) 649-3083
Entity
Organization

Contact information

Practice address
915 WESTCHESTER AVENUE, BRONX, NY 10457
(347) 649-3083
(347) 649-3090
Mailing address
308 EAST 175TH STREET, BRONX, NY 10457
(347) 649-3083
(347) 649-3090

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02357688
NY
Enumeration date
12/06/2006
Last updated
07/02/2018
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