Provider Demographics
NPI:1598578585
Name:NEW YORK STATE CENTER FOR ADVANCED ADULT SERVICES
Entity type:Organization
Organization Name:NEW YORK STATE CENTER FOR ADVANCED ADULT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORESTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-866-6089
Mailing Address - Street 1:3457 EASTCHESTER RD APT 3E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-1649
Mailing Address - Country:US
Mailing Address - Phone:212-866-6089
Mailing Address - Fax:212-866-6089
Practice Address - Street 1:3457 EASTCHESTER RD APT 3E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-1649
Practice Address - Country:US
Practice Address - Phone:212-866-6089
Practice Address - Fax:212-866-6089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No305R00000XManaged Care OrganizationsPreferred Provider Organization