Provider Demographics
NPI:1528231156
Name:SERVICES FOR THE UNDERSERVED
Entity Type:Organization
Organization Name:SERVICES FOR THE UNDERSERVED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNILLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-408-1630
Mailing Address - Street 1:305 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6008
Mailing Address - Country:US
Mailing Address - Phone:917-408-1611
Mailing Address - Fax:
Practice Address - Street 1:305 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6008
Practice Address - Country:US
Practice Address - Phone:917-408-1611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities