Provider Demographics
NPI:1235413535
Name:GERIATRIC RESOURCE CONSULTANTS CO. LLC
Entity Type:Organization
Organization Name:GERIATRIC RESOURCE CONSULTANTS CO. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CCM
Authorized Official - Phone:718-998-1999
Mailing Address - Street 1:1122 AVENUE Z
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5108
Mailing Address - Country:US
Mailing Address - Phone:718-998-1999
Mailing Address - Fax:718-998-9709
Practice Address - Street 1:1122 AVENUE Z
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5108
Practice Address - Country:US
Practice Address - Phone:718-998-1999
Practice Address - Fax:718-998-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1540L001251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care