Organization
MARTIN DE PORRES GROUP HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP ROFRANO LCSW (PRESIDENT EXECUTIVE DIRECTOR)
(718) 527-0606
Entity
Organization
Contact information
Practice address
136 25 218TH STREET, SPRINGFIELD GARDENS, NY 11413-2226
(718) 527-0606
(718) 723-1528
Mailing address
136 25 218TH STREET, SPRINGFIELD GARDENS, NY 11413-2226
(718) 527-0606
(718) 723-1528
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
00328116
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00328116
—
NY
Enumeration date
10/04/2006
Last updated
08/22/2020
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