Provider Demographics
NPI:1902865645
Name:MORNINGSIDE HOUSE ADULT DAY CARE
Entity Type:Organization
Organization Name:MORNINGSIDE HOUSE ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TURSONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-409-8225
Mailing Address - Street 1:1500 PELHAM PKWY S
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 PELHAM PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1100
Practice Address - Country:US
Practice Address - Phone:718-409-8225
Practice Address - Fax:718-409-8254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7000345N261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01006399Medicaid