NPIMap

Organization Active NPI

Bread of Life Community Service Inc.

  • Community/Behavioral Health Agency
  • Bronx, NY
National Provider Identifier
1336516988
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
082977 Issued in NY
Legal business name
BREAD OF LIFE COMMUNITY SERVICE INC.
Practice address
1055 Sherman Ave Apt 4B
Bronx, NY 10456-5720
Phone
(347) 892-5022
NPI assigned
Aug 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Authorized official

Name
Mr. Carlton L Jean, LCSW
Title
Ceo, President, Founder
Phone
(347) 892-5022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 082977 NY Primary

Addresses

Primary practice location

1055 Sherman Ave Apt 4B
Bronx, NY 10456-5720

Mailing address

1055 Sherman Ave Apt 4B
Bronx, NY 10456-5720
Phone (347) 892-5022

National Provider Directory

National Provider Directory
Tax ID family
Bread of Life Community Service Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1336516988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 SHERMAN AVE APT 4B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104565720",
            "telephone_number": "347-892-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 SHERMAN AVE APT 4B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104565720",
            "telephone_number": "347-892-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAD OF LIFE COMMUNITY SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO, PRESIDENT, FOUNDER",
        "authorized_official_telephone_number": "347-892-5022",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "082977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.