NPIMap

Organization Active NPI

Blended Case Management (Icl)

  • Community/Behavioral Health Agency
  • Brooklyn, NY
National Provider Identifier
1164549812
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BLENDED CASE MANAGEMENT (ICL)
Practice address
2384 Atlantic Ave
Brooklyn, NY 11233-3402
Phone
(718) 272-6025
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Authorized official

Name
Mr. Dewey H. Howard
Title
Cfo
Phone
(212) 385-3030

Specialties & licenses 1

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

Addresses

Primary practice location

2384 Atlantic Ave
Brooklyn, NY 11233-3402

Mailing address

125 Broad Street
3Rd Floor
New York, NY 10004-2400
Phone (212) 385-3030

Other identifiers 1

IdentifierTypeStateIssuer
02256077MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Icl Individual Support Services35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1164549812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BROAD STREET",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042400",
            "telephone_number": "212-385-3030",
            "fax_number": "917-831-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2384 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333402",
            "telephone_number": "718-272-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLENDED CASE MANAGEMENT (ICL)",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "DEWEY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "212-385-3030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02256077",
            "state": "NY"
        }
    ],
    "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 Jun 17, 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.