NPIMap

Organization Active NPI

Icl Garden House (Ave D) Icf

  • Mental Illness Intermediate Care Facility
  • Brooklyn, NY
National Provider Identifier
1013150531
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
Legal business name
ICL GARDEN HOUSE (AVE D) ICF
Practice address
4715 Avenue D
Icl Garden House (Ave D) Icf
Brooklyn, NY 11203
Phone
(718) 451-2817
NPI assigned
Apr 14, 2009
Last updated
Mar 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lynette Bacchus
Title
Asst Controller
Phone
(212) 385-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X Primary

Addresses

Primary practice location

4715 Avenue D
Icl Garden House (Ave D) Icf
Brooklyn, NY 11203

Mailing address

4715 Avenue D
Brooklyn, NY 11203-5817
Phone (718) 451-2817

National Provider Directory

National Provider Directory
Tax ID family
Icl Garden House Ave D Icf35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Locations

4715 Avenue D
Brooklyn, NY 11203
Phone (516) 476-0414

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1013150531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 AVENUE D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035817",
            "telephone_number": "718-451-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 AVENUE D",
            "address_2": "ICL GARDEN HOUSE (AVE D) ICF",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-451-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICL GARDEN HOUSE (AVE D) ICF",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "ASST CONTROLLER",
        "authorized_official_telephone_number": "212-385-3030",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.