NPIMap

Organization Active NPI

The Yaphank Center

  • Community/Behavioral Health Agency
  • Medford, NY
National Provider Identifier
1790147411
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
THE YAPHANK CENTER
Practice address
31 Industrial Blvd
Medford, NY 11763-2220
Phone
(631) 924-4411
NPI assigned
Mar 22, 2016
Last updated
Mar 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Authorized official

Name
Mr. John Mahon, LCSW-RNPI 1033434212
Title
Clinic Administrator
Phone
(631) 924-4411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

31 Industrial Blvd
Medford, NY 11763-2220

Mailing address

31 Industrial Blvd
Medford, NY 11763-2220

Other names 1

  • Pilgrim Psychiatric Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Wilton Devel Ctr Rev M269 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

31 Scouting Blvd
Medford, NY 11763
Phone (631) 924-4411

Practitioners & affiliated clinicians

Practitioners 44

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.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1790147411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 INDUSTRIAL BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 INDUSTRIAL BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220",
            "telephone_number": "631-924-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE YAPHANK CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "MAHON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "631-924-4411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pilgrim Psychiatric Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, NY

Sources for this page

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