NPIMap

Organization Active NPI

Kingsboro Addiction Treatment Center

  • Community/Behavioral Health Agency
  • Brooklyn, NY
National Provider Identifier
1790870913
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KINGSBORO ADDICTION TREATMENT CENTER
Practice address
754 Lexington Avenue
Brooklyn, NY 11221
Phone
(718) 453-3200
Fax
(718) 453-3378
NPI assigned
Oct 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael A Lawler
Title
Associate Commissioner Division of
Phone
(518) 457-5312

Specialties & licenses 1

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

Addresses

Primary practice location

754 Lexington Avenue
Brooklyn, NY 11221

Mailing address

754 Lexington Avenue
Brooklyn, NY 11221
Phone (718) 453-3200

Other identifiers 1

IdentifierTypeStateIssuer
01340541MedicaidNY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2098201Kingsboro Addiction Treatment Center754 Lexington Avenue, Brooklyn, NY 11221Certificate of waiverMar 26, 2027

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

754 Lexington Ave
Brooklyn, NY 11221
Phone (718) 453-3200

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790870913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 LEXINGTON AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11221",
            "telephone_number": "718-453-3200",
            "fax_number": "718-453-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 LEXINGTON AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11221",
            "telephone_number": "718-453-3200",
            "fax_number": "718-453-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSBORO ADDICTION TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAWLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASSOCIATE COMMISSIONER DIVISION OF",
        "authorized_official_telephone_number": "518-457-5312",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01340541",
            "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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.