Organization
MERCY HOME FOR CHILDEN, INC.,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SR. CATHERINE CRUMLISH (EXECUTIVE DIRECTOR)
(718) 832-1075
Entity
Organization
Contact information
Practice address
345 WARREN ST, BROOKLYN, NY 11201-6412
(718) 852-8613
(718) 852-2608
Mailing address
243 PROSPECT PARK WEST, BROOKLYN, NY 11215-5807
(718) 832-1075
(718) 499-9189
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00357011
MEDICAID PROVIDER ID #
NY
Enumeration date
02/29/2008
Last updated
03/11/2008
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