NPIMap

Organization Active NPI

Elmcor Youth and Adult Activities

  • Substance Abuse Rehabilitation Facility
  • Corona, NY
National Provider Identifier
1174994305
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
180711300 Issued in NY
Legal business name
ELMCOR YOUTH AND ADULT ACTIVITIES
Practice address
10720 Northern Blvd
Corona, NY 11368-1236
Phone
(718) 651-0096
Fax
(718) 457-3932
NPI assigned
Oct 14, 2015
Last updated
Oct 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Mr. Ropo Oyebode, MASTER IN ACCOUTING
Title
Finance Director
Phone
(718) 651-0096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 180711300 NY Primary

Addresses

Primary practice location

10720 Northern Blvd
Corona, NY 11368-1236

Mailing address

10720 Northern Blvd
Corona, NY 11368-1236
Phone (718) 651-0096

National Provider Directory

National Provider Directory
Tax ID family
Elmcor Youth and Adult Activities2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

10720 Northern Blvd
Corona, NY 11368
Phone (718) 651-0096

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1174994305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681236",
            "telephone_number": "718-651-0096",
            "fax_number": "718-457-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10720 NORTHERN BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681236",
            "telephone_number": "718-651-0096",
            "fax_number": "718-457-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMCOR YOUTH AND ADULT ACTIVITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "OYEBODE",
        "authorized_official_first_name": "ROPO",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "718-651-0096",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTER IN ACCOUTING"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "180711300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.