Provider Demographics
NPI:1689222622
Name:IRI: INNOVATIVE RESOURCES FOR INDEPENDENCE
Entity Type:Organization
Organization Name:IRI: INNOVATIVE RESOURCES FOR INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-947-6840
Mailing Address - Street 1:11240 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-2235
Mailing Address - Country:US
Mailing Address - Phone:347-947-6840
Mailing Address - Fax:718-776-3858
Practice Address - Street 1:235 JEROME ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3209
Practice Address - Country:US
Practice Address - Phone:347-947-6840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities