Provider Demographics
NPI:1255822052
Name:CENTRAL PARK WEST CARE LLC
Entity type:Organization
Organization Name:CENTRAL PARK WEST CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:TSE-HSIN
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-358-5800
Mailing Address - Street 1:13677 ROOSEVELT AVE # 2A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5585
Mailing Address - Country:US
Mailing Address - Phone:718-358-5800
Mailing Address - Fax:
Practice Address - Street 1:115-119 LENOX AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11026
Practice Address - Country:US
Practice Address - Phone:718-358-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No174200000XOther Service ProvidersMeals
No282E00000XHospitalsLong Term Care Hospital