National Provider Identifier Database

CATH CHAR NGHBHD SVS MUGAVERO ICF
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

CATH CHAR NGHBHD SVS MUGAVERO ICF
14516 FARMERS BLVD
JAMAICA, NY11434-5024
Phone: 718-712-9054
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for CATH CHAR NGHBHD SVS MUGAVERO ICF

NPI Number 1194868257
Legal business name
LBN
CATH CHAR NGHBHD SVS MUGAVERO ICF
Authorized official DONNA CORRADO - (EXECUTIVE SECRETARY)
Entity Organization
Organization subpart Yes
Enumeration date 02/15/2007
Last updated 07/09/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • NY Medicaid: 01128821

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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