NPIMap

Organization Active NPI

Suffolk County Department of Health

  • Adult Mental Health Clinic/Center
  • Great River, NY
National Provider Identifier
1639530082
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
212750 Issued in NY
Legal business name
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Practice address
3500 Sunrise Hwy
Great River, NY 11739-1001
Phone
(631) 854-0100
NPI assigned
Mar 14, 2016
Last updated
Mar 14, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MENTAL HEALTH CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Authorized official

Name
James Tomarken, MD
Title
Commissioner of Health
Phone
(631) 854-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 212750 NY Primary

Addresses

Primary practice location

3500 Sunrise Hwy
Great River, NY 11739-1001

Mailing address

3500 Sunrise Hwy
PO Box 9006
Great River, NY 11739-1001
Phone (631) 854-0100

Other identifiers 1

IdentifierTypeStateIssuer
00355019MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Patricia a Centamore17 organizations share this tax ID, including this one
Part of
Patricia a Centamore

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1639530082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 SUNRISE HWY",
            "address_2": "PO BOX 9006",
            "city": "GREAT RIVER",
            "state": "NY",
            "postal_code": "117391001",
            "telephone_number": "631-854-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SUNRISE HWY",
            "city": "GREAT RIVER",
            "state": "NY",
            "postal_code": "117391001",
            "telephone_number": "631-854-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK COUNTY DEPARTMENT OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MENTAL HEALTH CLINIC",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "TOMARKEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "COMMISSIONER OF HEALTH",
        "authorized_official_telephone_number": "631-854-0100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "212750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.