Organization
THE WARTBURG HOME OF THE EVANGELICAL LUTHERAN CHURCH, INC.
Active
Other names
Wartburg Adult Day Services Medical Model
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GENTNER (CEO/PRESIDENT)
(914) 513-5311
Entity
Organization
Contact information
Practice address
1 WARTBURG PL, MOUNT VERNON, NY 10552-3821
(914) 699-0800
(914) 699-2512
Mailing address
1 WARTBURG PL, MOUNT VERNON, NY 10552-3821
(914) 699-0800
(914) 699-2512
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
5903309N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01024437
MMIS
NY
Enumeration date
10/25/2016
Last updated
10/25/2016
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