Provider Demographics
NPI:1407529514
Name:THE ECHELON SOCIETY INC
Entity Type:Organization
Organization Name:THE ECHELON SOCIETY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:FERNANDES
Authorized Official - Suffix:
Authorized Official - Credentials:CRPA
Authorized Official - Phone:149-219-4239
Mailing Address - Street 1:20 E 1ST ST STE 302
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-3375
Mailing Address - Country:US
Mailing Address - Phone:914-219-4239
Mailing Address - Fax:914-221-7805
Practice Address - Street 1:20 E 1ST ST STE 302
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-3375
Practice Address - Country:US
Practice Address - Phone:914-219-4239
Practice Address - Fax:914-221-7805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251V00000XAgenciesVoluntary or Charitable
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty