Provider Demographics
NPI:1689992588
Name:AHRC
Entity Type:Organization
Organization Name:AHRC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LLIWELYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:646-752-8730
Mailing Address - Street 1:3171 LAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1512
Mailing Address - Country:US
Mailing Address - Phone:646-752-8730
Mailing Address - Fax:
Practice Address - Street 1:3171 LAYTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1512
Practice Address - Country:US
Practice Address - Phone:646-752-8730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility