Puerto Rican Organization to Motivate Enlighten and Serve Addicts, Inc
Organization Active NPI Substance Abuse Rehabilitation Facility · Bronx, NY
NPI 1295911063 · NPPES record last updated Sep 23, 2022
Key facts
- NPI
- 1295911063
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 080811627 (NY)
- Legal business name
- PUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS, INC
- Practice address
- 1776 Clay Ave
Bronx, NY 10457 - Phone
- (718) 299-1100
- Fax
- (718) 716-7822
- NPI assigned
- Jan 11, 2008
- Organization subpart
- No
Authorized official
- Name
- Vicky Gatell
- Title
- Chief Financial Officer
- Phone
- (718) 960-7629
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 6
Practitioners 16
-
Dinelsi Almonte, LMSW
-
Mamadou Diallo, LMSW
-
William Tarrant, LCSW
-
Esther Aguirre, NP
-
Abigail Ionie Caesar, LCSW
-
Lisbeth Maria Camilo, MSW
-
Nafiysa James, LCSW
-
Melody Melendez, LMSW
-
Manuel Orlando Mosquera, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY
- Opioid treatment program
- Medicare-enrolled since Jan 1, 2020
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315000368 | NY | Part B Supplier - Clinic/Group Practice | 5395634539 |
Receives reassigned benefits from 6 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bronx, NY |
| O20200218000961 | NY | Part B Supplier - Opioid Treatment Program (Otp) | 5395634539 |
5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Albany, NY; Bronx, NY; Brooklyn, NY; Buffalo, NY; Dunkirk, NY |
National Provider Directory
- Tax ID family
- Promesa Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 8157008A | NY | |
| Substance Abuse Rehabilitation Facility | 324500000X | 080811627 | NY | Yes |
Addresses
Primary practice location
1776 Clay Ave
Bronx, NY 10457
Mailing address
311 E 175TH St
Bronx, NY 10457-5859
Phone (718) 960-7568
Other practice location 1
915 Westchester Ave
Bronx, NY 10459-3009
Phone (718) 764-1570
Other practice location 2
175 Central Ave
Albany, NY 12206-2937
Phone (518) 729-5659
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02892868 | Medicaid | NY |
Other names
- Promesa Inc
Other providers in Bronx, NY
- Puerto Rican Home Attendants Services, Inc
- Puerto Rican Organization to Motivate Enlighten and Serve Addicts Inc
- Puerto Rican Organization to Motivate Enlighten and Serve Addicts Inc
- Puerto Rican Organization to Motivate Enlighten and Serve Addicts Inc
- Puerto Rican Organization to Motivate Enlighten and Serve Addicts Inc
- Puerto Rican Organization to Motivate Enlighten and Serve Addicts, Inc
- Puerto Rican Organization to Motivate, Enlighten and Serve Addicts, Inc
- Lauren Pueschel
- Leigh F Pughe
- Rocchina Pugliese
All providers in Bronx, NY · Substance Abuse Rehabilitation Facility in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.