Provider Demographics
NPI:1497089858
Name:MID-BRONX SENIOR CITIZENS COUNCIL, SERVICES
Entity Type:Organization
Organization Name:MID-BRONX SENIOR CITIZENS COUNCIL, SERVICES
Other - Org Name:COMFORTING CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PURYEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:718-588-8200
Mailing Address - Street 1:900 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2746
Mailing Address - Country:US
Mailing Address - Phone:718-588-8200
Mailing Address - Fax:718-681-3824
Practice Address - Street 1:900 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2746
Practice Address - Country:US
Practice Address - Phone:718-588-8200
Practice Address - Fax:718-681-3824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0331L001251E00000X, 372500000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty