NPIMap

Organization Active NPI

Sanctuary East LTD.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • East Islip, NY
National Provider Identifier
1972560167
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
070210970 Issued in NY
Legal business name
SANCTUARY EAST LTD.
Practice address
2 William Ave
East Islip, NY 11730-2330
Phone
(631) 224-7700
Fax
(631) 224-7600
NPI assigned
Apr 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Authorized official

Name
Lorenzo Rodriguez, A.A., CASACNPI 1518246503
Title
Director
Phone
(631) 224-7700

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
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 070210970 NY Primary

Addresses

Primary practice location

2 William Ave
East Islip, NY 11730-2330

Mailing address

2 William Ave
East Islip, NY 11730-2330
Phone (631) 224-7700

Other identifiers 9

IdentifierTypeStateIssuer
160171OtherNYVALUE OPTIONS
01853901MedicaidNY
004629536OtherNYAETNA
105727591OtherNYUBH
577470000OtherNYMAGELLAN
MH20235OtherNYHIP
023048OtherNYEMPIRE B/C B/S
1058710OtherNYBEACON HEALTH
OL987078OtherNYGHI

National Provider Directory

National Provider Directory

Locations

2 William Ave
East Islip, NY 11730
Phone (631) 224-7700

Practitioners & affiliated clinicians

Practitioners 8

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": "1146355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1972560167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WILLIAM AVE",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302330",
            "telephone_number": "631-224-7700",
            "fax_number": "631-224-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WILLIAM AVE",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302330",
            "telephone_number": "631-224-7700",
            "fax_number": "631-224-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY EAST LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-30",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "LORENZO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-224-7700",
        "authorized_official_credential": "A.A., CASAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "070210970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "160171",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01853901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "004629536",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "105727591",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "577470000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "MH20235",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE B/C B/S",
            "identifier": "023048",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH",
            "identifier": "1058710",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "OL987078",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.