Organization
COMMUNITY RESOURCE CENTER FOR THE DEVELOPMENTALLY DISABLED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN M MEADE (EXECUTIVE DIRECTOR)
(718) 292-1705
Entity
Organization
Contact information
Practice address
245 E 149TH ST, BRONX, NY 10451-5516
(718) 292-1705
Mailing address
378 E 151ST ST, BRONX, NY 10455-2603
(718) 292-1705
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00346492
—
NY
Enumeration date
12/15/2006
Last updated
10/11/2007
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