NPIMap

Organization Active NPI

Freeport Pride

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Freeport, NY
National Provider Identifier
1144619966
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
161210916 Issued in NY
Legal business name
FREEPORT PRIDE
Practice address
33 Guy Lombardo Ave
Freeport, NY 11520-3637
Phone
(516) 546-2822
NPI assigned
Jan 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Ms. Yolanda Carrion, LCSW, CASAC
Title
Assistant Director
Phone
(516) 546-2822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 161210916 NY Primary

Addresses

Primary practice location

33 Guy Lombardo Ave
Freeport, NY 11520-3637

Mailing address

500 Cooper CT
Uniondale, NY 11553-2108
Phone (516) 483-5772

National Provider Directory

National Provider Directory
Tax ID family
Freeport Pride Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1144619966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COOPER CT",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115532108",
            "telephone_number": "516-483-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 GUY LOMBARDO AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203637",
            "telephone_number": "516-546-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEPORT PRIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "CARRION",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "516-546-2822",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, CASAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "161210916",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 16, 2015; 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.