EBONY EYES COMMUNITY SERVICES CENTER INC. (NPI# 1568018505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568018505 |
| Entity Type | Organization |
| Organization Name | EBONY EYES COMMUNITY SERVICES CENTER INC. |
| Practice Address |
1646 Andrews Ave Apt 3 Bronx NY 10453-7347 |
| Practice Telephone | 9175443151 |
| Mailing Telephone | 9175443151 |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-08-15 |
| Authorized Official Name | MS. EBONY ALTINA SANJURJO I (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9175443151 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EBONY EYES COMMUNITY SERVICES CENTER INC. | 1646 Andrews Ave Apt 3, Bronx, NY 10453-7347 |
| Street Address |
1646 ANDREWS AVE APT 3 |
| City | BRONX |
| State | NY |
| Zip Code | 10453-7347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553225 | Victor Felipe | Occupational Therapist | 2042 Grand Avenue, Apartment 2d, Ny, Apt 2d, Bronx, NY 10453 | 2020-09-17 |
| 1033745849 | Jennifer Vargas | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems Dept of Dentistry, 1775 Grand Concourse 6th Floor, Bronx, NY 10453 | 2020-03-13 |
| 1457985038 | John Steven Contreras | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems, Dept of Dentistry, 1775 Grand Concourse 6th Floor, Bronx, NY 10453 | 2020-02-24 |
| 1538799648 | Ari Warshawsky | Counselor | Postgraduate Center for Mental Health, 1775 Grand Concourse, 8th Floor, Bronx, NY 10453 | 2020-01-17 |
| 1407403413 | Cristaly Williams | Behavioral Analyst | 2105 Jerome Avenue, Bronx, NY 10453 | 2019-08-23 |
| 1770041204 | Yei Won Lee | Student in an Organized Health Care Education/Training Program | Bronxcare Health Systems, Dental Dept, 1775 Grand Concourse, 6th Floor, Bronx, NY 10453 | 2019-03-04 |
| 1265905517 | William Alexander Jones Jr. | Behavior Technician | 1749grand Concourse, 1749 Grand Concourse Apt Ph8, Bronx, NY 10453 | 2019-01-09 |
| 1154810737 | Emily Patricia Mitchell | Occupational Therapist | 2105 Jerome Ave, Bronx, NY 10453 | 2018-05-09 |
| 1417445149 | Ashna N Shah | Student in an Organized Health Care Education/Training Program | Bronx Lebanon Hospital Center 6 Th Floor, 1775 Grand Concourse, Bronx, NY 10453 | 2018-04-27 |
| 1700384328 | Kevin Ponce Obate | Physical Therapist | 1975 University Ave, Bronx, NY 10453 | 2018-01-29 |
| Find all providers in zip 10453 | ||||
| Taxonomy Code | 385HR2060X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740798396 | Michael Mccain | Respite Care | 80-09 Winchester Blvd, Queens Village, NY 11427 | 2018-01-17 |
| 1194233049 | Khalia Hollinshead | Respite Care | 160 Lakewood Ave, Roosevelt, NY 11575-1441 | 2018-01-12 |
| 1730606377 | Emani, Inc. | Respite Care | 5 Hagen Ct., Coram, NY 11727 | 2017-08-24 |
| 1912442070 | Bluemoon Health Management | Respite Care | 196 Buffalo Ave, Suite 3b, Brooklyn, NY 11213-3283 | 2016-12-28 |
| 1891243093 | Nia Alyssa Donawa | Respite Care | 39 Sammis Ave, Deer Park, NY 11729-6717 | 2016-09-15 |
| 1255889457 | Christine Hanley | Respite Care | 113 Timberline Dr, Brentwood, NY 11717-5712 | 2016-09-15 |
| 1083161590 | Applied Behavior Interventions | Respite Care | 114 Washington St, Mount Vernon, NY 10550-3514 | 2016-09-01 |
| 1760862486 | Meaningful Ny Initiatives for People With Disabilities, Inc. | Respite Care | 1 Pierrepont Plz Fl 12, 300 Cadman Plaza West, Brooklyn, NY 11201-2776 | 2015-06-08 |
| 1396164273 | Danielle Marie Maher | Respite Care | 6911 58th Rd, Maspeth, NY 11378-2603 | 2014-04-08 |
| 1164861092 | Therapeutic Equesterian Center | Respite Care | 115 Stone Crop Ln, Cold Spring, NY 10516-3681 | 2013-06-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.