Mission of the Immaculate Virgin

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

7943430 Issued in NY

Legal business name

MISSION OF THE IMMACULATE VIRGIN

Practice address

6581 Hylan Blvd
Staten Island, NY 10309-3830

Phone

(718) 317-2803

Fax

(718) 317-2830

NPI assigned

Dec 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Stephen W Rynn

Title

Executive Director

Phone

(718) 317-2803

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mission of the Immaculate2 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.

• Mission of the Immaculate

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Staten Island, NY
  • NPI 1750570495
  NPD tax ID

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1982886958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6581 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093830",
            "telephone_number": "718-317-2803",
            "fax_number": "718-317-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6581 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093830",
            "telephone_number": "718-317-2803",
            "fax_number": "718-317-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION OF THE IMMACULATE VIRGIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "RYNN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-317-2803",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NY",
            "license": "7943430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02002633",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esther Misrahi Elting, MSOTR/L
• Christopher Missak, D.O.
• Brittany Anne Misseri
• Mission of the Immaculate
• Mission of the Immaculate Virgin
• Charles J Mistretta, D.D.S.
• Jaclyn Mistretta, LCSW
• Mitchell a. Schuman, MD,PC
• Catherine Mitchell, OTR/L
• Janet Mitchell

• Case Management Agency in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Case Management Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.