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General NPI Number Information
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NPI Number | 1275927600
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Entity Type | Organization
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Legal Business Name | RISEWELL COMMUNITY SERVICES
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 240A LONG ISLAND AVE
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City | WYANDANCH
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State | NY
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Zip | 11798-3123
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Country | US
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Telephone | 631-782-6200
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Fax | 631-491-5354
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Provider Business Mailing Address
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Address Line | 1 FARMINGDALE ROAD ROUTE 109
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City | WEST BABYLON
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State | NY
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Zip | 11704
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Country | US
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Telephone | 631-669-5355
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Fax | 631-669-5355
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | STEPHEN MCCARTHY
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Credential | CFO
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Telephone | 631-669-5355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NY
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