Organization Name: | DAMIAN FAMILY CARE CENTERS, INC. |
NPI Number: | 1003294307 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN CHUE (CFO) |
Mailing Address: | 13802 Queens Blvd 2nd Floor Briarwood |
State: | NY US |
Postal Code: | 114352642 |
Phone Number: | 7186571100 |
Fax Number: | 7186571870 |
NPI Enumeration Date: | 05/07/2015 |
NPI Last Update Date: | 05/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | 7003246R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |