Organization Active NPI

Evelyn Douglin Center Spin

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Brooklyn, NY
National Provider Identifier
1972049039
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
EVELYN DOUGLIN CENTER SPIN
Practice address
163 Riverdale Ave
Brooklyn, NY 11212-5579
Phone
(718) 965-1998
NPI assigned
Jan 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Authorized official

Name
Daniella Volcy
Title
Aed
Phone
(718) 965-1998

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NY Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X

Addresses

Primary practice location

163 Riverdale Ave
Brooklyn, NY 11212-5579

Mailing address

241 37TH St
Brooklyn, NY 11232-2417
Phone (718) 965-1998

Other identifiers 2

IdentifierTypeStateIssuer
9058471MedicaidNY
9058472MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Evelyn Douglin Center Spin2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1972049039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 37TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322417",
            "telephone_number": "718-965-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 RIVERDALE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112125579",
            "telephone_number": "718-965-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN DOUGLIN CENTER SPIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-13",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "VOLCY",
        "authorized_official_first_name": "DANIELLA",
        "authorized_official_title_or_position": "AED",
        "authorized_official_telephone_number": "718-965-1998"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9058471",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9058472",
            "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 Feb 15, 2017; 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.