Provider Demographics
NPI:1164049078
Name:CHRISTOPHER ROSE COMMUNITY EMPOWERMENT CAMPAIGN
Entity Type:Organization
Organization Name:CHRISTOPHER ROSE COMMUNITY EMPOWERMENT CAMPAIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COOMBS-ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-272-2363
Mailing Address - Street 1:772 VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-7009
Mailing Address - Country:US
Mailing Address - Phone:718-272-2363
Mailing Address - Fax:718-272-0406
Practice Address - Street 1:1404 BROOKLYN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210
Practice Address - Country:US
Practice Address - Phone:718-282-7232
Practice Address - Fax:718-282-7231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable