Organization
PERSON CENTERED CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRIS MARCHIONNE (EXECUTIVE DIRECTOR)
(718) 370-1088
Entity
Organization
Contact information
Practice address
150 GRANITE AVE, STATEN ISLAND, NY 10303-2718
(718) 370-1088
Mailing address
150 GRANITE AVE, STATEN ISLAND, NY 10303-2718
(718) 370-1088
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NY
251C00000X
Developmentally Disabled Services Day Training Agency
—
NY
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NY
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02725139
MEDICAID PROVIDER ID
NY
01
—
02749686
MEDICAID PROVIDER ID
NY
01
—
02750076
MEDICAID PROVIDER ID
NY
01
—
02750549
MEDICAID PROVIDER ID
NY
01
—
02952876
MEDICAID PROVIDER ID
NY
01
—
03762094
MEDICAID PROVIDER ID
NY
Enumeration date
04/03/2015
Last updated
04/03/2015
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