Provider Demographics
NPI:1619201258
Name:HOME FOR AGED BLIND
Entity Type:Organization
Organization Name:HOME FOR AGED BLIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-769-6215
Mailing Address - Street 1:15 W 65TH ST
Mailing Address - Street 2:FINANCE DEPARTMENT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6601
Mailing Address - Country:US
Mailing Address - Phone:212-769-6200
Mailing Address - Fax:212-769-7838
Practice Address - Street 1:15 W 65TH ST
Practice Address - Street 2:FINANCE DEPARTMENT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6601
Practice Address - Country:US
Practice Address - Phone:212-769-6200
Practice Address - Fax:212-769-7838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JHB HEALTH FACILITY CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00309320Medicaid
NY335512OtherMEDICARE