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Organization

UPPER ROOM AIDS MINISTRY, INC. ADULT DAY HEALTH CARE CENTER.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMISHA MCPHERSON MBA (EXECUTIVE DIRECTOR)
(212) 803-2850
Entity
Organization

Contact information

Practice address
169 W 133RD ST, NEW YORK, NY 10030-3301
(646) 762-4950
(646) 762-4953
Mailing address
306 LENOX AVENUE, 3RD FLOOR, NEW YORK, NY 10027-4920
(212) 803-2850
(212) 803-2899

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
104100000X
Social Worker
1041C0700X
Clinical Social Worker
1223G0001X
General Practice Dentistry
2084P0800X
Psychiatry Physician
251S00000X
Community/Behavioral Health Agency
261Q00000X
Clinic/Center
Primary
261QA0600X
Adult Day Care Clinic/Center
261QF0050X
Non-Surgical Family Planning Clinic/Center
261QF0400X
Federally Qualified Health Center (FQHC)
261QP1100X
Podiatric Clinic/Center
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01741726
NY
01
33/1040 AND 33/1041
MEDICARE PART A
NY
01
A100140369
MEDICARE PART B
NY
Enumeration date
07/02/2006
Last updated
09/05/2019
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