Organization
BETHABRAHAM HOSPITAL
Active
Other names
Bainbridge Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORNA DECARLA INNIS OTA (OTA/OTA)
(646) 415-1121
Entity
Organization
Contact information
Practice address
3936 BARNES AVE, BRONX, NY 10466-4313
(646) 415-1121
Mailing address
3936 BARNES AVE, BRONX, NY 10466-4313
(646) 415-1121
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
006625-1
NY
252Y00000X
Early Intervention Provider Agency
006625-1
NY
273Y00000X
Rehabilitation Hospital Unit
Primary
006625-1
NY
302R00000X
Health Maintenance Organization
006625-1
NY
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
006625-1
NY
Other
Enumeration date
07/29/2010
Last updated
07/29/2010
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