SLS Residential Inc

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

8490002 Issued in NY

Legal business name

SLS RESIDENTIAL INC

Practice address

2505 Carmel Ave
Suite 210
Brewster, NY 10509

Phone

(845) 279-5994

Fax

(845) 279-7678

NPI assigned

Feb 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Betsy Bergman

Title

Administrator Cfo

Phone

(845) 279-5994

Specialties & licenses 1

Addresses

Other names 1

• Supervised Lifestyles SIS Health Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Paul Gureasko Moore, PHD

  • Psychologist
  • Brewster, NY
  • NPI 1972723013
  NPD (past)
• Linda Padroff, LCSW

  • Clinical Social Worker
  • Brewster, NY
  • NPI 1699811927
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780725069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 CARMEL AVE",
            "address_2": "SUITE 210",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "10509",
            "telephone_number": "845-279-5994",
            "fax_number": "845-279-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 CARMEL AVE",
            "address_2": "SUITE 210",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "10509",
            "telephone_number": "845-279-5994",
            "fax_number": "845-279-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLS RESIDENTIAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "BETSY",
        "authorized_official_title_or_position": "ADMINISTRATOR CFO",
        "authorized_official_telephone_number": "845-279-5994"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NY",
            "license": "8490002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supervised Lifestyles SIS Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sharee Skalsky, LCSW
• Jennifer Rose Skov, COTA
• Jolanta Skrzypczyk, RPH
• Heather Sloan, RN
• Susan Juliet Sloane, RDH
• Gary Tyquan Smith
• Coleen E. Snow, LCSW
• Fernando E Solis, PT DPT
• Sammy Soto Lopez
• Southeast Medical

• Psychiatric Residential Treatment Facility in Brewster, NY
• Providers in Brewster, NY by specialty
• Psychiatric Residential Treatment Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.