NPIMap

Organization Active NPI

Catholic Charities of the Diocese of Rockville Centre

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Freeport, NY
National Provider Identifier
1124063862
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
6814431 Issued in NY
Legal business name
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
Practice address
333 No. Main St
Freeport, NY 11520-1231
Phone
(516) 733-7040
Fax
(513) 733-7098
NPI assigned
Jun 17, 2006
Last updated
May 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Richard Balcom
Title
Cfo
Phone
(516) 733-7032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 6814431 NY Primary

Addresses

Primary practice location

333 No. Main St
Freeport, NY 11520-1231

Mailing address

90 Cherry LN
Hicksville, NY 11801-6232
Phone (516) 733-7000

Other identifiers 1

IdentifierTypeStateIssuer
01303497MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of the Diocese of Rockville Centre26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1124063862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CHERRY LN",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016232",
            "telephone_number": "516-733-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NO. MAIN ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201231",
            "telephone_number": "516-733-7040",
            "fax_number": "513-733-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "BALCOM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-733-7032"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NY",
            "license": "6814431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01303497",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.