Intake Connect Child Services LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

INTAKE CONNECT CHILD SERVICES LLC

Practice address

6171 Tyndall Ave
Bronx, NY 10471-1118

Phone

(917) 942-9963

NPI assigned

May 11, 2023

Organization subpart

No

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

Authorized official

Name

Gelda Vasquez Agustin

Title

President

Phone

(917) 942-9963

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gelda Vasquez

  • Case Manager/Care Coordinator
  • Forest Hills, NY
  • NPI 1699156042
  NPD

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1013607019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6171 TYNDALL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6171 TYNDALL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711118",
            "telephone_number": "917-942-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTAKE CONNECT CHILD SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ AGUSTIN",
        "authorized_official_first_name": "GELDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-942-9963"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.