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1427991298 NPI number — RISEWELL COMMUNITY SERVICES

NPI Number: 1427991298
Health Care Provider/Practitioner: RISEWELL COMMUNITY SERVICES

Information about “1427991298” NPI (RISEWELL COMMUNITY SERVICES) exists in 1427991298 in HTML format HTML  |  1427991298 in plain Text format TXT  |  1427991298 in PDF (Portable Document Format) PDF  |  1427991298 in an XML format XML  formats.

NPI Number : 1427991298 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1427991298",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RISEWELL COMMUNITY SERVICES",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1 FARMINGDALE ROAD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEST BABYLON",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11704-6545",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "631-663-5355",
    "MailingAddressFaxNumber": "631-669-1114",
    "FirstLinePracticeLocationAddress": "87 E LAKEWOOD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PATCHOGUE",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11772-2819",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "631-576-8354",
    "PracticeLocationAddressFaxNumber": "631-207-8438",
    "EnumerationDate": "04/14/2026",
    "LastUpdateDate": "04/14/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MCCARTHY",
    "AuthorizedOfficialFirstName": "STEPHEN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CHIEF FINANCIAL OFFICER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CFO",
    "AuthorizedOfficialTelephoneNumber": "631-669-5355",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "320800000X",
        "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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