NPIMap

Organization Active NPI

De Trinity Community Living Corp

  • Developmentally Disabled Services Day Training Agency
  • Middletown, NY
National Provider Identifier
1447763271
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
DE TRINITY COMMUNITY LIVING CORP
Practice address
25 Gordon Rd
Middletown, NY 10941-3346
Phone
(646) 400-4562
Fax
(347) 274-2478
NPI assigned
Nov 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Ejovwoke Riesa
Title
Ceo
Phone
(646) 400-4562

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Respite Care 385H00000X

Addresses

Primary practice location

25 Gordon Rd
Middletown, NY 10941-3346

Mailing address

25 Gordon Rd
Middletown, NY 10941-3346
Phone (646) 400-4562

National Provider Directory

National Provider Directory
Tax ID family
De Trinity Community Living Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1447763271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GORDON RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109413346",
            "telephone_number": "646-400-4562",
            "fax_number": "347-274-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 GORDON RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109413346",
            "telephone_number": "646-400-4562",
            "fax_number": "347-274-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE TRINITY COMMUNITY LIVING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "RIESA",
        "authorized_official_first_name": "EJOVWOKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-400-4562"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.