NPIMap

Organization Active NPI

Residential Experience in Adult Living, Inc

  • Professional Counselor
  • Freeport, NY
National Provider Identifier
1932230026
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
RESIDENTIAL EXPERIENCE IN ADULT LIVING, INC
Doing business as
Project REAL
Practice address
55 N Ocean Ave
2ND Floor
Freeport, NY 11520
Phone
(516) 223-9570
Fax
(516) 223-8076
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Authorized official

Name
Mrs. Kathleen M Malizia, LMSW, MSNPI 1790497980
Title
Executive Director
Phone
(516) 223-9570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

55 N Ocean Ave
2ND Floor
Freeport, NY 11520

Mailing address

55 N Ocean Ave
2ND Floor
Freeport, NY 11520
Phone (516) 223-9570

Other names 1

  • Project REAL Doing business as

National Provider Directory

National Provider Directory

Locations

55 N Ocean Ave
Ste 2
Freeport, NY 11520
Phone (516) 223-9570

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1932230026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N OCEAN AVE",
            "address_2": "2ND FLOOR",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-223-9570",
            "fax_number": "516-223-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N OCEAN AVE",
            "address_2": "2ND FLOOR",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-223-9570",
            "fax_number": "516-223-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL EXPERIENCE IN ADULT LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "MALIZIA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-223-9570",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW, MS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Project REAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.