Provider Demographics
NPI:1164983482
Name:CARE FOR THE HOMELESS
Entity Type:Organization
Organization Name:CARE FOR THE HOMELESS
Other - Org Name:CARE FOR THE HOMELESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:FLYNN
Authorized Official - Last Name:OLASIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-355-4459
Mailing Address - Street 1:30 E 33RD ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5337
Mailing Address - Country:US
Mailing Address - Phone:212-366-4459
Mailing Address - Fax:347-823-1561
Practice Address - Street 1:3600 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1052
Practice Address - Country:US
Practice Address - Phone:212-366-4459
Practice Address - Fax:212-366-4585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE FOR THE HOMELESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-28
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty