Active NPI
Welllife Network Inc
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Maspeth, NY
National Provider Identifier
1083778583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- License
- 01203025
- Legal business name
- WELLLIFE NETWORK INC
- Practice address
- 5232 72ND PL
Maspeth, NY 11378-1516 - Phone
- (718) 779-7931
- NPI assigned
- Dec 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Lori Alameda
- Title
- Senior Vice President - CFP
- Phone
- (347) 542-5616
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | 01203025 | NY | Primary |
Addresses
Primary practice location
5232 72ND PL
Maspeth, NY 11378-1516
Mailing address
142-02 20TH Avenue
Flushing, NY 11351-9712
Phone (718) 559-0516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01203025 | Medicaid | NY |
Other names 1
- Promoting Specialized Care & Health
National Provider Directory
National Provider Directory- Tax ID family
- Promoting Specialized Care Health
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Organizations that report the same tax identification number in the National Provider Directory.
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Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1608076800000",
"number": "1083778583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142-02 20TH AVENUE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113519712",
"telephone_number": "718-559-0516",
"fax_number": "718-762-6140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5232 72ND PL",
"city": "MASPETH",
"state": "NY",
"postal_code": "113781516",
"telephone_number": "718-779-7931"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLLIFE NETWORK INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-20",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A",
"authorized_official_last_name": "ALAMEDA",
"authorized_official_first_name": "LORI",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT - CFP",
"authorized_official_telephone_number": "347-542-5616",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NY",
"license": "01203025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01203025",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Promoting Specialized Care & Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Promoting Specialized Care & Health",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Maspeth, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.