NPIMap

Organization Active NPI

Catholic Charities of the Diocese of Rockville Centre

  • Substance Abuse Rehabilitation Facility
  • Bohemia, NY
National Provider Identifier
1346772019
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
12049 Issued in NY
Legal business name
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
Practice address
30 Carlough Rd Ste C
Bohemia, NY 11716-2919
Phone
(631) 589-4144
Fax
(631) 589-3281
NPI assigned
Mar 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Authorized official

Name
Mr. Richard Balcom
Title
Cfo
Phone
(516) 733-7032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 12049 NY Primary

Addresses

Primary practice location

30 Carlough Rd Ste C
Bohemia, NY 11716-2919

Mailing address

90 Cherry LN
Hicksville, NY 11801-6232
Phone (516) 733-7040

Other identifiers 1

IdentifierTypeStateIssuer
12049OtherNYOASAS OPERATING CERTIFICATE

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of the Diocese of Rockville Centre26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

30 Carlough Rd
Ste C
Bohemia, NY 11716
Phone (631) 589-3229

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1346772019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CHERRY LN",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016232",
            "telephone_number": "516-733-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CARLOUGH RD STE C",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117162919",
            "telephone_number": "631-589-4144",
            "fax_number": "631-589-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-31",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "BALCOM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-733-7032",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "12049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OASAS OPERATING CERTIFICATE",
            "identifier": "12049",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.