NPIMap

Organization Active NPI

Institute for Community Living

  • Community/Behavioral Health Agency
  • Brooklyn, NY
National Provider Identifier
1629226915
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
074164 Issued in NY
Legal business name
INSTITUTE FOR COMMUNITY LIVING
Practice address
2384 Atlantic Avenue
Brooklyn, NY 11322
Phone
(212) 385-3030
Fax
(212) 385-2380
NPI assigned
Aug 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Dr. Peter Campanelli
Title
President
Phone
(212) 385-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 074164 NY Primary

Addresses

Primary practice location

2384 Atlantic Avenue
Brooklyn, NY 11322

Mailing address

40 Rector St
New York, NY 10006-1705
Phone (212) 385-3030

Other identifiers 1

IdentifierTypeStateIssuer
01551404MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Icl Individual Support Services35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1629226915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 RECTOR ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061705",
            "telephone_number": "212-385-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2384 ATLANTIC AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11322",
            "telephone_number": "212-385-3030",
            "fax_number": "212-385-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR COMMUNITY LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "CAMPANELLI",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-385-3030",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "074164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01551404",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.