| Institute For Community Living , Inc. | |
|
13607 Brookville Blvd Rosedale NY 11422-1525 | |
| (718) 855-7485 | |
| Not Available |
| Full Name | Institute For Community Living , Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13607 Brookville Blvd, Rosedale, New York |
| Authorized Official Name and Position | Renie Elizabeth Marie Rondon Jackson (CLINIC DIRECTOR) |
| Authorized Official Contact | 7188557485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Institute For Community Living , Inc. 136 Rockville Blvd Rosedale NY 11422-0000 Ph: (718) 855-7485 | Institute For Community Living , Inc. 13607 Brookville Blvd Rosedale NY 11422-1525 Ph: (718) 855-7485 |
| NPI Number | 1427105857 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427105857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 057800 (New York) | Primary |
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