Provider Demographics
NPI:1336642040
Name:REFUGEE & IMMIGRANT SELF-EMPOWERMENT
Entity Type:Organization
Organization Name:REFUGEE & IMMIGRANT SELF-EMPOWERMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAJI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-214-4480
Mailing Address - Street 1:302 BURT ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3911
Mailing Address - Country:US
Mailing Address - Phone:315-214-4480
Mailing Address - Fax:
Practice Address - Street 1:302 BURT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3911
Practice Address - Country:US
Practice Address - Phone:315-214-4480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health