NPIMap

Organization Active NPI

Risewell Community Services

  • Community/Behavioral Health Agency
  • Glen Cove, NY
National Provider Identifier
1740355783
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
03007747 Issued in NY
Legal business name
RISEWELL COMMUNITY SERVICES
Practice address
103 Frost Pond Rd
Glen Cove, NY 11542-4008
Phone
(516) 674-4251
Fax
(516) 674-8453
NPI assigned
Nov 22, 2006
Last updated
Aug 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Mr. Stephen McCarthy, CFO
Title
Chief Financial Officer
Phone
(631) 669-5355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 03007747 NY Primary

Addresses

Primary practice location

103 Frost Pond Rd
Glen Cove, NY 11542-4008

Mailing address

1 Farmingdale Road Route 109
West Babylon, NY 11704
Phone (631) 669-5355

Other identifiers 1

IdentifierTypeStateIssuer
03007747MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Federation of Organizations30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1740355783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FARMINGDALE ROAD ROUTE 109",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "11704",
            "telephone_number": "631-669-5355",
            "fax_number": "631-669-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FROST POND RD",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115424008",
            "telephone_number": "516-674-4251",
            "fax_number": "516-674-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISEWELL COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "631-669-5355",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "03007747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03007747",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.