Provider Demographics
NPI:1992193874
Name:DAMIAN FAMILY CARE CENTERS, INC.
Entity Type:Organization
Organization Name:DAMIAN FAMILY CARE CENTERS, INC.
Other - Org Name:PROTECT SAMARITAN HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:718-657-1100
Mailing Address - Street 1:138-02 QUEENS BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:718-657-1100
Mailing Address - Fax:718-657-1870
Practice Address - Street 1:137-50 JAMAICA AVENUE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435
Practice Address - Country:US
Practice Address - Phone:718-298-5100
Practice Address - Fax:718-298-5128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003246R261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)