Provider Demographics
NPI:1396049987
Name:COMMUNITY ASSISTANCE RESOURCES & EXTENDED SERVICES INC
Entity type:Organization
Organization Name:COMMUNITY ASSISTANCE RESOURCES & EXTENDED SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HR ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STATFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-420-1970
Mailing Address - Street 1:465 GRAND ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4800
Mailing Address - Country:US
Mailing Address - Phone:212-420-1970
Mailing Address - Fax:
Practice Address - Street 1:465 GRAND ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4800
Practice Address - Country:US
Practice Address - Phone:212-420-1970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02939577Medicaid
NY02991880Medicaid
NY02991904Medicaid
NY8382001AOtherNYSOMH
NY03966507Medicaid