Provider Demographics
NPI:1194099739
Name:ELMCOR YOUTH AND ADULT ACTIVITIES, INC
Entity type:Organization
Organization Name:ELMCOR YOUTH AND ADULT ACTIVITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRAUMA SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-651-0096
Mailing Address - Street 1:3316 108TH ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-1224
Mailing Address - Country:US
Mailing Address - Phone:718-651-0096
Mailing Address - Fax:718-457-3932
Practice Address - Street 1:3316 108TH ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-1224
Practice Address - Country:US
Practice Address - Phone:718-651-0096
Practice Address - Fax:718-457-3932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty