Provider Demographics
NPI:1043560717
Name:QUEENS HERALD COMMUNITY CORPORATION
Entity Type:Organization
Organization Name:QUEENS HERALD COMMUNITY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-939-3606
Mailing Address - Street 1:6515 164TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2651
Mailing Address - Country:US
Mailing Address - Phone:646-389-6418
Mailing Address - Fax:646-349-2318
Practice Address - Street 1:6515 164TH ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2651
Practice Address - Country:US
Practice Address - Phone:646-389-6418
Practice Address - Fax:646-349-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care