CATHOLIC GUARDIAN SOCIETY & HOME BUREAU
Intermediate Care Facility, Mentally Retarded
New York, New York
Provider NPI: 1215004353
Organization Information:Organization Name: CATHOLIC GUARDIAN SOCIETY & HOME BUREAU
Practice Location:
107 PAYSON AVE NEW YORK, NY 10034 US
Tel: 212-567-2847 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
107 PAYSON AVE NEW YORK, NY 10034 US
Tel: 212-567-2847 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
00356905 | NY | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin