Organization
PRIME RIV
Active
Other names
Brooklyn Kitchen
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY MARTIN JANSEN (DIRECTOR)
(610) 283-8706
Entity
Organization
Contact information
Practice address
2780 STILLWELL AVE, BROOKLYN, NY 11224-2722
(718) 371-0025
Mailing address
2780 STILLWELL AVE, BROOKLYN, NY 11224-2722
(610) 283-8706
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
332U00000X
Home Delivered Meals
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
07/24/2026
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