NPIMap

Organization Active NPI

Selfhelp Alzheimers Resource Program

  • Home Health Agency
  • Bayside, NY
National Provider Identifier
1245528231
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
030L003 Issued in NY
Legal business name
SELFHELP ALZHEIMERS RESOURCE PROGRAM
Practice address
208-11 26TH Avenue
Bayside, NY 11360
Phone
(212) 971-7726
NPI assigned
Jul 12, 2011
Organization subpart
Yes
Parent organization
SELFHELP COMMUNITY SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Authorized official

Name
Mr. Russell Lusal
Title
Vice President, Administration
Phone
(212) 971-7707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 030L003 NY Primary

Addresses

Primary practice location

208-11 26TH Avenue
Bayside, NY 11360

Mailing address

520 8TH Ave
New York, NY 10018-6507
Phone (212) 971-7726

Other identifiers 1

IdentifierTypeStateIssuer
03191848MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Selfhelp Community Services Inc4 organizations share this tax ID, including this one
Part of
Selfhelp Community Services Inc

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1245528231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 8TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100186507",
            "telephone_number": "212-971-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208-11 26TH AVENUE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11360",
            "telephone_number": "212-971-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELFHELP ALZHEIMERS RESOURCE PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELFHELP COMMUNITY SERVICES, INC",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "LUSAL",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "VICE PRESIDENT, ADMINISTRATION",
        "authorized_official_telephone_number": "212-971-7707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "030L003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03191848",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.