NPIMap

Organization Active NPI

Risewell Community Services

  • Community/Behavioral Health Agency
  • West Brentwood, NY
National Provider Identifier
1083789028
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
03007710 Issued in NY
Legal business name
RISEWELL COMMUNITY SERVICES
Practice address
998 Crooked Hill Rd
Building #55
West Brentwood, NY 11717-1019
Phone
(631) 236-4299
Fax
(631) 235-4126
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Mr. Stephen McCarthy, CFO
Title
Chief Financial Officer
Phone
(631) 669-5355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 03007710 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
Building #55
West Brentwood, NY 11717-1019

Mailing address

1 Farmingdale Road Route 109
West Babylon, NY 11704
Phone (631) 669-5355

Other identifiers 1

IdentifierTypeStateIssuer
03007710MedicaidNY

Other names 1

  • Federation of Organizations for th NYS Mentally Disabled Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Risewell Community Services30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1083789028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FARMINGDALE ROAD ROUTE 109",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "11704",
            "telephone_number": "631-669-5355",
            "fax_number": "631-669-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "address_2": "BUILDING #55",
            "city": "WEST BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-236-4299",
            "fax_number": "631-235-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISEWELL COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "631-669-5355",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "03007710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03007710",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Federation of Organizations for th NYS Mentally Disabled",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.