NPIMap

Organization Active NPI

Community Resource Center for the Developmentally Disabled, Inc.

  • Mental Illness Intermediate Care Facility
  • New York, NY
National Provider Identifier
1689733008
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
Legal business name
COMMUNITY RESOURCE CENTER FOR THE DEVELOPMENTALLY DISABLED, INC.
Practice address
2253 3Rd Ave
New York, NY 10035-2206
Phone
(718) 292-1705
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Mr. Kevin M Meade
Title
Executive Director
Phone
(718) 292-1705

Specialties & licenses 1

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

Addresses

Primary practice location

2253 3Rd Ave
New York, NY 10035-2206

Mailing address

378 E 151St St
Bronx, NY 10455-2603
Phone (718) 292-1705

Other identifiers 1

IdentifierTypeStateIssuer
00357180MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Community Resource Center for the Developmentally Disabled Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1689733008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 E 151ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104552603",
            "telephone_number": "718-292-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352206",
            "telephone_number": "718-292-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESOURCE CENTER FOR THE DEVELOPMENTALLY DISABLED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "MEADE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-292-1705",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357180",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.