Organization
PUERO RICAN FAMILY ICF # 3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL CINA (CONTROLLER)
(212) 229-6921
Entity
Organization
Contact information
Practice address
145 W 15TH ST FL 2, NEW YORK, NY 10011-6701
(212) 414-7822
(212) 691-5635
Mailing address
194 W 180TH ST, BRONX, NY 10453-2905
(212) 414-7822
(212) 691-5635
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
06482441
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01113304
—
NY
Enumeration date
04/02/2008
Last updated
04/02/2008
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