BROOKVILLE CENTER FOR CHILDRENS SERVICES INC (NPI# 1053558940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053558940 |
| Entity Type | Organization |
| Organization Name | BROOKVILLE CENTER FOR CHILDRENS SERVICES INC |
| Practice Address |
100 Red Spring Ln Glen Cove NY 11542-1754 |
| Mailing Address |
189 Wheatley Rd Glen Head NY 11545-2641 |
| Practice Telephone | 5166261075 |
| Practice Fax Number | 5166263308 |
| Mailing Telephone | 5166261075 |
| Mailing Fax Number | 5166263308 |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |
| Authorized Official Name | MR. WILLARD T DERR (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5166261075 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003053885 | Brookville Center for Childrens Services Inc | Intermediate Care Facility, Mental Illness | 28 Seaspray Dr, Lido Beach, NY 11561-5232 | 2009-01-15 |
| 1457598237 | Brookville Center for Childrens Services Inc | Intermediate Care Facility, Mental Illness | 30 Seaspray Dr, Lido Beach, NY 11561-5232 | 2009-01-15 |
| 1376780262 | Brookville Center for Childrens Services Inc | Intermediate Care Facility, Mental Illness | 26 Seaspray Dr, Lido Beach, NY 11561-5232 | 2009-01-14 |
| Street Address |
100 RED SPRING LN |
| City | GLEN COVE |
| State | NY |
| Zip Code | 11542-1754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104468461 | Yvonne N Valcourt | Registered Nurse | 14 Burns Ave, Glen Cove, NY 11542 | 2019-10-08 |
| 1508419771 | Gregory Stephen Bonistalli | Audiologist | 70 Glen St Ste 100, Glen Cove, NY 11542 | 2019-07-17 |
| 1861954646 | Pulkit Malik | Student in an Organized Health Care Education/Training Program | Northwell Health Glen Cove Hospital, 101 St. Andrews Lane, Glen Cove, NY 11542 | 2019-04-02 |
| 1912498783 | Rays of Light Companion Care Agency LLC | Long Term Care Hospital | 70 Forest Ave # 2g, Glen Cove, NY 11542 | 2018-05-28 |
| 1164978391 | Nithin Kuruvilla | Pharmacist | 421 Glen Cove Road, East Hills, NY 11542 | 2016-08-28 |
| 1063879245 | Kerri A Sujeski | Physician Assistant | 104 Forest Avenue, Glen Cove, NY 11542 | 2016-01-19 |
| 1093110884 | Sherri Meagher | Social Worker | 130 Glen Street, Glen Cove, NY 11542 | 2014-10-23 |
| 1174946537 | Lori Seele | Psychologist | Ridge Drive, Connolly Elementary School, Glen Cove, NY 11542 | 2014-01-21 |
| 1255671210 | Wendy S Grossman | Speech-Language Pathologist | 2 Dosoris Lane, Deasy School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-27 |
| 1033459318 | Kristin Strelec | Social Worker | Seaman & Walnut Roads, Gribbin School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-22 |
| Find all providers in zip 11542 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013189935 | Sco Family of Services | Intermediate Care Facility, Mental Illness | 1 Alexander Place, Glen Cove, NY 11542 | 2008-04-01 |
| 1104098029 | Sco Family of Services | Intermediate Care Facility, Mental Illness | 1 Alexander Pl, Glen Cove, NY 11542-3745 | 2008-04-01 |
| 1396809273 | Sco Family of Services | Intermediate Care Facility, Mental Illness | 1 Alexander Pl, Glen Cove, NY 11542-3745 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619537271 | Citizens Options Unlimited Inc | Intermediate Care Facility, Mental Illness | 283 Route 25a, Shoreham, NY 11786-2135 | 2019-06-17 |
| 1508300393 | Citizens Options Unlimited Inc | Intermediate Care Facility, Mental Illness | 915 Rainbow Commons Court, Melville, NY 11747-9001 | 2016-12-13 |
| 1871037648 | Citizens Options Unlimited Inc | Intermediate Care Facility, Mental Illness | 919 Rainbow Commons Court, Melville, NY 11747-9001 | 2016-12-13 |
| 1972967859 | Citizens Options Unlimited Inc | Intermediate Care Facility, Mental Illness | 904 Melville Estates Ct, Melville, NY 11747-2827 | 2016-04-07 |
| 1326400631 | Qsac, Inc | Intermediate Care Facility, Mental Illness | 901 Melville Estates Ct, Melville, NY 11747-2827 | 2016-03-25 |
| 1225317266 | Easter Seals New York, Inc. | Intermediate Care Facility, Mental Illness | 304 Daley Blvd, Rochester, NY 14617 | 2011-08-09 |
| 1407135445 | Easter Seals New York, Inc. | Intermediate Care Facility, Mental Illness | 404 Rogers Pkwy, Rochester, NY 14617 | 2011-08-09 |
| 1316226350 | Easter Seals of Ny, Inc | Intermediate Care Facility, Mental Illness | 302 Daley Boulevard, Rochester, NY 14617 | 2011-08-09 |
| 1114213824 | Gotham | Intermediate Care Facility, Mental Illness | 116 John St., New York, NY 10038-3414 | 2011-06-21 |
| 1215240403 | Nassau County Association for The Help of Retarded Citizens Inc | Intermediate Care Facility, Mental Illness | 980 Washington Ave., House D, Plainview, NY 11803 | 2010-07-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.