ELMCOR YOUTH AND ADULT ACTIVITIES (NPI# 1174994305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174994305 |
| Entity Type | Organization |
| Organization Name | ELMCOR YOUTH AND ADULT ACTIVITIES |
| Practice Address |
10720 Northern Blvd Corona NY 11368-1236 |
| Practice Telephone | 7186510096 |
| Practice Fax Number | 7184573932 |
| Mailing Telephone | 7186510096 |
| Mailing Fax Number | 7184573932 |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |
| Authorized Official Name | MR. ROPO OYEBODE (FINANCE DIRECTOR) |
| Authorized Official Telephone | 7186510096 |
| Authorized Official Credential | MASTER IN ACCOUT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 180711300 | NY | Residential Treatment Facilities |
| Street Address |
10720 NORTHERN BLVD |
| City | CORONA |
| State | NY |
| Zip Code | 11368-1236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609909910 | Elmcor Youth & Adult Activities Inc | Clinic/Center | 10720 Northern Blvd, Corona, NY 11368-1236 | 2007-03-14 |
| 1437412608 | Raymond Dejean Jr. | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-06-21 |
| 1437410404 | Luis M Montero | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-06-06 |
| 1366716615 | Maria Ramirez | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-03-05 |
| 1679846422 | Edgar Vargas | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2012-02-09 |
| 1760788855 | Robert V Kennedy | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2011-02-07 |
| 1215161765 | Fay Kendall | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2009-05-13 |
| 1295972438 | Olga Treguboff | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2009-01-09 |
| 1073759031 | Michael Quinones | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2008-12-22 |
| 1992941959 | George Acevedo | Counselor | 10720 Northern Blvd, Corona, NY 11368-1236 | 2008-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760014039 | Marukh Naeem | Behavioral Analyst | 11119a Roosevelt Ave, Apt 2r, Apt 2r, Corona, NY 11368 | 2020-02-05 |
| 1164072989 | Tonyia Michelle Madison | Counselor | 34-10 108 Street, Corona, Queens, NY 11368 | 2019-09-13 |
| 1962987347 | Sinead Anel Ulloa | Speech-Language Pathologist | 10420 37th Rd, Corona, NY 11368 | 2018-10-01 |
| 1245725779 | Bracha Namdar | Optometrist | 103-06 Roosevelt Ave, Corona, NY 11368 | 2018-06-27 |
| 1548758220 | Karina Elizabeth Carrasco | Specialist | 96- 32 46th Ave, Corona, NY 11368 | 2018-04-27 |
| 1134634033 | Nicole Iuculano | Speech-Language Pathologist | 43-18 97th Place, Corona, NY 11368 | 2017-12-13 |
| 1558880831 | Abenaa Nyame Danquah | Registered Nurse | 55-25 98th Place, Apt 1k, Corona, NY 11368 | 2017-09-18 |
| 1063940443 | Brand Rx Pharmacy Corp | Pharmacy | 97-05 A 57th Avenue, Corona, NY 11368 | 2017-05-30 |
| 1427595909 | Richelle Krish Sumaoy Colmenares | Physical Therapist | 3744 104th St., Corona, New York City, NY 11368 | 2017-01-23 |
| 1235674342 | 39th Avenue Physical Therapy PC | Clinic/Center | 103-18c 39 Ave, Corona, NY 11368 | 2016-12-28 |
| Find all providers in zip 11368 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295377570 | Daylight Recovery Services, LLC | Substance Abuse Rehabilitation Facility | 518 Queensland Cir Ste 101, Corona, CA 92879-1381 | 2019-10-08 |
| 1306355144 | Ridgeview Recovery LLC | Substance Abuse Rehabilitation Facility | 1216 Cleveland Way, Corona, CA 92881-5906 | 2017-09-25 |
| 1083136188 | Blvd Centers, Inc. | Substance Abuse Rehabilitation Facility | 518 Queensland Cir, Corona, CA 92879-1381 | 2017-07-10 |
| 1578084257 | San Diego Detox | Substance Abuse Rehabilitation Facility | 9440 Pats Point Dr, Corona, CA 92883-5014 | 2017-07-03 |
| 1043768484 | San Diego Detox | Substance Abuse Rehabilitation Facility | 9480 Pats Point Dr, Corona, CA 92883-5014 | 2016-09-14 |
| 1265888622 | Casa Contenta Recovery Group, Inc. | Substance Abuse Rehabilitation Facility | 8431 Weirick Rd, Corona, CA 92883-4994 | 2016-05-04 |
| 1225409584 | Reflections Recovery, LLC | Substance Abuse Rehabilitation Facility | 630 Gregory Cir, Corona, CA 92881-3596 | 2015-10-13 |
| 1043698509 | Darlene Leon | Substance Abuse Rehabilitation Facility | 13757 Aspen Leaf Ln, Corona, CA 92880-0721 | 2015-05-15 |
| 1376186718 | Daylight Recovery Services | Substance Abuse Rehabilitation Facility | 9440 Pats Point Dr, Corona, CA 92883-5014 | 2019-10-17 |
| 1922640580 | Daylight Recovery Services, LLC | Substance Abuse Rehabilitation Facility | 9480 Pats Point Dr, Corona, CA 92883-5014 | 2019-10-15 |
| Find all providers in CORONA | ||||
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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.