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General NPI Number Information
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NPI Number | 1144438078
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Entity Type | Organization
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Legal Business Name | MELILLO CENTER FOR MENTAL HEALTH
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 85 RED GROUND RD
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1709
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Country | US
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Telephone | 516-484-8983
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Fax | 516-759-5259
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Provider Business Mailing Address
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Address Line | 113 GLEN COVE AVE
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City | GLEN COVE
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State | NY
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Zip | 11542-3438
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Country | US
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Telephone | 516-676-2388
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Fax | 516-759-5259
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. DANIEL J. VOGRIN
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Credential | PH.D.
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Telephone | 516-676-2388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 6804432
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License Number State | NY
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