NPIMap

Organization Active NPI

South Beach Psych Center(Omh)

  • Home Health Agency
  • Staten Island, NY
National Provider Identifier
1306209283
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SOUTH BEACH PSYCH CENTER(OMH)
Practice address
777 Seaview Avenue
Health Home Care Dept
Staten Island, NY 10305
Phone
(718) 668-8082
Fax
(718) 668-8070
NPI assigned
Mar 30, 2016
Organization subpart
Yes
Parent organization
HOME HEALTH CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Lance L Goldson, SOCIAL WORKER ASST 3
Title
Icm
Phone
(718) 668-8082

Specialties & licenses 1

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

Addresses

Primary practice location

777 Seaview Avenue
Health Home Care Dept
Staten Island, NY 10305

Mailing address

777 Seaview Avenue
Health Home Care Dept.
Staten Island, NY 10305
Phone (718) 668-8082

Other identifiers 1

IdentifierTypeStateIssuer
00769306MedicaidNY

Other names 1

  • South Beach Psychiatric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Middletown Psychiatric Center146 organizations share this tax ID, including this one
Part of
Middletown Psychiatric Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306209283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVENUE",
            "address_2": "HEALTH HOME CARE DEPT.",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-668-8082",
            "fax_number": "718-668-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVENUE",
            "address_2": "HEALTH HOME CARE DEPT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-668-8082",
            "fax_number": "718-668-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BEACH PSYCH CENTER(OMH)",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOME HEALTH CARE",
        "enumeration_date": "2016-03-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOLDSON",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ICM",
        "authorized_official_telephone_number": "718-668-8082",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SOCIAL WORKER ASST 3"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00769306",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Beach Psychiatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.