Provider Demographics
NPI:1134598840
Name:YORK INDEPENDENT LIVING LLC
Entity type:Organization
Organization Name:YORK INDEPENDENT LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MELQUISEDEC
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-769-8744
Mailing Address - Street 1:7422 NEW UTRECHT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5138
Mailing Address - Country:US
Mailing Address - Phone:917-769-8744
Mailing Address - Fax:
Practice Address - Street 1:7422 NEW UTRECHT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5138
Practice Address - Country:US
Practice Address - Phone:917-769-8744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health