NPIMap

Organization Active NPI

Odyssey House, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bronx, NY
National Provider Identifier
1013976976
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ODYSSEY HOUSE, INC
Practice address
953 Southern Blvd RM 301
Bronx, NY 10459-3428
Phone
(718) 860-2994
NPI assigned
Mar 20, 2006
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chiyo Jikko
Title
Assistant Controller
Phone
(212) 361-1600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

953 Southern Blvd RM 301
Bronx, NY 10459-3428

Mailing address

120 Wall St Ste 1700
New York, NY 10005-4001
Phone (212) 361-1600

Other practice location 1

1328 Clinton Ave
Bronx, NY 10456-2548
Phone (718) 378-8995

Other practice location 2

13 Hell Gate Cir
New York, NY 10035-6602
Phone (212) 426-6633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160513000860 NY Part B Supplier - Clinic/Group Practice 2264323393 Receives reassigned benefits from 3 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Tax ID family
Odyssey House of Ny Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

120 Wall St
Ste 1700
New York, NY 10005

95 Pine St
Fl 17
New York, NY 10005

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1013976976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WALL ST STE 1700",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100054001",
            "telephone_number": "212-361-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 SOUTHERN BLVD RM 301",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593428",
            "telephone_number": "718-860-2994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1328 Clinton Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104562548",
            "country_code": "US",
            "telephone_number": "718-378-8995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13 Hell Gate Cir",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100356602",
            "country_code": "US",
            "telephone_number": "212-426-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ODYSSEY HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "JIKKO",
        "authorized_official_first_name": "CHIYO",
        "authorized_official_title_or_position": "ASSISTANT CONTROLLER",
        "authorized_official_telephone_number": "212-361-1600"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.