Provider Demographics
NPI:1770848913
Name:ETIENNE SOCIAL DAY CARE
Entity Type:Organization
Organization Name:ETIENNE SOCIAL DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-239-3094
Mailing Address - Street 1:1696 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6408
Mailing Address - Country:US
Mailing Address - Phone:718-287-4400
Mailing Address - Fax:718-287-4600
Practice Address - Street 1:1696 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6408
Practice Address - Country:US
Practice Address - Phone:718-287-4400
Practice Address - Fax:718-287-4600
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ETIENNE HOME CARE SERVICES,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care