Provider Demographics
NPI:1700915493
Name:EAST HARLEM COUNCIL FOR COMMUNITY IMPROVEMENT
Entity Type:Organization
Organization Name:EAST HARLEM COUNCIL FOR COMMUNITY IMPROVEMENT
Other - Org Name:EHCCI
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL RIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-649-3083
Mailing Address - Street 1:413 E 120TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3602
Mailing Address - Country:US
Mailing Address - Phone:212-410-7707
Mailing Address - Fax:
Practice Address - Street 1:413 E 120TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3602
Practice Address - Country:US
Practice Address - Phone:212-410-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY82220813385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02663927Medicaid