Provider Demographics
NPI:1942553441
Name:UNIQUE CARE COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:UNIQUE CARE COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AEON
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-502-2956
Mailing Address - Street 1:2046 E 64TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5912
Mailing Address - Country:US
Mailing Address - Phone:347-446-5594
Mailing Address - Fax:718-504-5304
Practice Address - Street 1:9317 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4806
Practice Address - Country:US
Practice Address - Phone:347-502-2956
Practice Address - Fax:718-504-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-21
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251G00000XAgenciesHospice Care, Community Based
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child