St George Community Center 1, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

ST GEORGE COMMUNITY CENTER 1, INC.

Practice address

6209 11TH Ave
Brooklyn, NY 11219-5205

Phone

(929) 305-3003

Fax

(718) 524-9421

NPI assigned

Jun 21, 2019

Organization subpart

No

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

Authorized official

Name

Mina Kolta

Title

Director of Programs

Phone

(929) 305-3003

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1578124582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 11TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195205",
            "telephone_number": "929-305-3003",
            "fax_number": "718-524-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 11TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195205",
            "telephone_number": "929-305-3003",
            "fax_number": "718-524-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GEORGE COMMUNITY CENTER 1, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "KOLTA",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "DIRECTOR OF PROGRAMS",
        "authorized_official_telephone_number": "929-305-3003"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcella St Clair, LCSW
• Raymond St Felix, MD
• Vanessa St Fleur
• Chantale St Fort
• St George Ault Day Care Center Inc
• Gerd St Germain, PA
• Roothchild St Germain
• Jeanne St Hilaire, FNP
• Marie Dolores St Hubin
• Shella St Ima

• Adult Care Home Facility in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Care Home Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.