Re-Entry Link

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RE-ENTRY LINK

Practice address

1451 West Ave Ste 1-11
Bronx, NY 10462

Phone

(347) 997-5465

Fax

(877) 333-8118

NPI assigned

Oct 22, 2008

Organization subpart

No

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

Authorized official

Name

Jennifer Ellison-Lackard

Title

Founder

Phone

(347) 995-5465

Specialties & licenses 6

Addresses

Other identifiers 1

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1184876104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 WEST AVE STE 1-11",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104627304",
            "telephone_number": "347-997-5465",
            "fax_number": "877-333-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 WEST AVE STE 1-11",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10462",
            "telephone_number": "347-997-5465",
            "fax_number": "877-333-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RE-ENTRY LINK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "ELLISON-LACKARD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "347-995-5465"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "12345678",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.