Provider Demographics
NPI:1457650392
Name:SCO FAMILY OF SERVICES
Entity Type:Organization
Organization Name:SCO FAMILY OF SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-671-1253
Mailing Address - Street 1:1 ALEXANDER PL
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-3745
Mailing Address - Country:US
Mailing Address - Phone:516-759-1844
Mailing Address - Fax:516-759-6921
Practice Address - Street 1:1250 E 229TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-5851
Practice Address - Country:US
Practice Address - Phone:718-405-7060
Practice Address - Fax:718-405-6069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities