Organization
COMMUNITY HEALTH CENTER OF RICHMOND, INC
Active
Other names
Richmond Community Support Organization
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIE GABRIEL (DIRECTOR OF PATIENT FINANCIAL SERVI)
(718) 924-2254
Entity
Organization
Contact information
Practice address
235 PORT RICHMOND AVENUE, STATEN ISLAND, NY 10302-1701
(718) 876-1732
(718) 442-0189
Mailing address
235 PORT RICHMOND AVENUE, STATEN ISLAND, NY 10302-1701
(718) 924-2254
(718) 442-0189
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2903588
NY
261QP2300X
Primary Care Clinic/Center
7004210R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2903588
—
NY
01
—
7004210R
OPERATING CERTIFICATE #
NY
Enumeration date
05/23/2007
Last updated
09/24/2013
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