Provider Demographics
NPI:1760719306
Name:PSYCHOTHERAPY COUNSELING AND HOME CARE OF GREATER NEW YORK INC.
Entity Type:Organization
Organization Name:PSYCHOTHERAPY COUNSELING AND HOME CARE OF GREATER NEW YORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-677-6422
Mailing Address - Street 1:464 W 141ST ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-6202
Mailing Address - Country:US
Mailing Address - Phone:347-677-6422
Mailing Address - Fax:212-810-2890
Practice Address - Street 1:464 WESTB141 STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-6202
Practice Address - Country:US
Practice Address - Phone:347-677-6422
Practice Address - Fax:212-810-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9408L001313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility