NPIMap

Organization Active NPI

Revcore Recovery Center of Manhattan, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
National Provider Identifier
1154094555
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
REVCORE RECOVERY CENTER OF MANHATTAN, LLC
Practice address
15 2ND Ave FL 3
Brooklyn, NY 11215-2711
Phone
(718) 514-6007
NPI assigned
Jul 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Authorized official

Name
Avraham Schick
Title
Chief Executive Officer
Phone
(212) 966-9537

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

15 2ND Ave FL 3
Brooklyn, NY 11215-2711

Mailing address

15 2ND Ave FL 3
Brooklyn, NY 11215-2711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220518001475 NY Part B Supplier - Clinic/Group Practice 7517344278 Receives reassigned benefits from 16 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Tax ID family
Revcore Recovery Center of Manhattan LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

15 2nd Ave
Fl 3
Brooklyn, NY 11215
Phone (718) 514-6007

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1154094555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 2ND AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 2ND AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152711",
            "telephone_number": "718-514-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVCORE RECOVERY CENTER OF MANHATTAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "SCHICK",
        "authorized_official_first_name": "AVRAHAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "212-966-9537"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.